QA Team Lead - Clinical Denials
Work setup: ONSITE / BGC, Taguig within 6 months then transfer to Bridgetowne, QC
Work schedule: Nightshift
The QA Team Lead – Clinical Denials provides day-to-day leadership and oversight for the quality assurance function supporting Clinical Denials operations. The position is responsible for ensuring consistent application of QA standards, audit methodology, quality scorecards, coaching practices, and client-specific requirements.
The QA Team Lead oversees QA activities, monitors quality performance, conducts complex and escalated audits, leads calibration activities, identifies systemic quality issues, and partners with operational leadership to implement corrective and preventive actions.
This role serves as a subject-matter expert and quality resource for Clinical Denials Specialists, Team Leads, Managers, and other revenue cycle stakeholders.
Qualifications
Required
- Bachelor's degree in Nursing, Healthcare Administration, Health Information Management, or related healthcare field.
- Active RN license or applicable clinical credential.
- Minimum 4 to 5 years of healthcare experience in clinical denials, CDI, utilization management, coding, RCM, appeals, or related areas.
- Minimum 1 to 2 years of QA, auditing, team leadership, or supervisory experience.
- Strong knowledge of cl
