QA/ Process Specialist - RCM

Overview

RCM QA/Process Specialist responsible for QA audits, work allocation, client interactions, and generating RCM metrics reports for leadership.

What you'll do

• Perform quality checks/audits on claims processed as per quality policy or client SOP.
• Ensure claims are processed in compliance with billing rules and identify errors before re-billing.
• Implement Lean Six Sigma methodologies to improve process accuracy.
• Prepare daily, weekly, and monthly audit metrics reports and share with leadership.
• Analyze audit findings and present summaries to leadership in an actionable format.
• Review audit parameters and modify them based on requirements.
• Suggest process improvements and set up calibration sessions with onshore and internal teams.

What you'll need

• 3+ years of industry experience.
• 2+ years of experience in relevant RCM functions performing quality audits.
• Hands-on experience with MS Excel and MS PowerPoint for reporting.
• Strong ability to analyze raw data and develop actionable recommendations.
• Ability to handle multiple reporting tasks simultaneously.
• Solid verbal and written communication skills.

Details

• Location: Bangalore, India (South 3rd Floor).