RCM Quality Analyst

Job Posting: RCM Quality Analyst

Location: Visakhapatnam, India
Department: Revenue Cycle Management (RCM)
Type: Full-Time

Position Overview:

We are looking for a detail-oriented and analytical Revenue Cycle Management Quality Analyst to join our team in Visakhapatnam. The RCM Quality Analyst will be responsible for evaluating and improving the quality of revenue cycle processes, ensuring accuracy, compliance, and efficiency in all operations. The ideal candidate will have a keen eye for detail, strong analytical skills, and a deep understanding of healthcare revenue cycle management.

Key Responsibilities:

• Quality Monitoring: Assess the accuracy and quality of revenue cycle processes, including eligibility verification, billing, coding, claims submission, and payment posting.
• Quality and Process Auditing: Conduct regular audits of RCM production and processes to identify discrepancies, errors, and areas for improvement.
• Data Analysis: Analyze data to identify trends, root causes of errors, and opportunities for process optimization.
• Compliance: Ensure all RCM activities comply with relevant regulations, including HIPAA, ICD-10, and payer-specific guidelines.
• Reporting: Prepare detailed reports on audit findings, quality metrics, and improvement recommendations for management.
• Feedback & Training: Provide constructive feedback to the RCM teams, team members and assist in training initiatives to enhance accuracy and efficiency.
• Continuous Improvement: Collaborate with the RCM team to implement process improvements and standardization efforts.
• Documentation: Maintain accurate and up-to-date documentation of quality assurance activities and audit results.

Requirements

Qualifications:

• Education: Bachelor’s degree in healthcare administration, finance, business, or a related field.
• Experience: Minimum of 2-4 years of experience in revenue cycle management, with a focus on quality assurance or auditing.
• Technical Skills: Proficiency in RCM software, electronic health records (EHR), and medical billing systems.
• Knowledge: In-depth understanding of healthcare billing, coding, and reimbursement processes, including knowledge of ICD-10, CPT, and HCPCS codes.
• Analytical Skills: Strong ability to analyze data, identify trends, and provide actionable insights.
• Attention to Detail: Exceptional attention to detail, with a focus on accuracy and compliance.
• Communication Skills: Excellent verbal and written communication skills, with the ability to present findings clearly and effectively.
• Problem-Solving: Ability to identify issues and propose effective solutions to enhance process quality.
• Team Collaboration: Experience working in a team-oriented environment, with a collaborative approach to problem-solving.

Additional information

• Fixed Night Shift
• Salary Best in the Industry
• Allowances
• Insurance Benefits