Quality Manager - Revenue Cycle Management (RCM)
- Leading Client
- 10 - 17 years
- Chennai
- 9 hours ago
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Job Description
Key Responsibilities
- 10-12 years of experience in RCM with at least 3+ years in a quality leadership role Develop and implement quality assurance frameworks across RCM processes Conduct regular audits of coding, billing, and AR processes Ensure adherence to payer guidelines, client SOPs, and regulatory standards (HIPAA, CMS, etc ) Monitor accuracy, productivity, and compliance metrics
- Process Improvement Identify quality gaps and root causes of errors Drive continuous improvement initiatives (Lean, Six Sigma, etc ) Collaborate with operations teams to reduce denials and improve first-pass yield Standardize best practices across teams 3
- Team Management Lead and mentor QA analysts and auditors Set performance goals and KPIs for the quality team Conduct regular training and calibration sessions Ensure consistency in audit scoring and feedback
- Reporting Analytics Prepare and present quality dashboards and reports to leadership and clients Track KPIs such as accuracy rates, denial rates, turnaround time, and rework Provide actionable insights to improve operational performance
- Compliance Risk Management Ensure compliance with healthcare regulations (HIPAA, ICD-10, CPT, HCPCS) Conduct internal compliance audits Support external audits and client reviews Mitigate risks related to billing errors and revenue leakage 6
- Client Interaction Act as a quality SPOC for clients Participate in client calls and business reviews Address client escalations related to quality issues Align quality goals with client expectations
- Key Skills Competencies Strong knowledge of end-to-end RCM processes
- Expertise in medical coding, billing, and denial management Analytical and problem-solving skills Leadership and stakeholder management
- Excellent communication and presentation skills Familiarity with quality tools and methodologies
Contact Person: Devikala D
Email: de*****a@go***s.biz
Job Classification
Industry: Analytics / KPO / ResearchFunctional Area / Department: Customer Success, Service & OperationsRole Category: OperationsRole: Operations ManagerEmployement Type: Full timeContact Details:
Company: Leading ClientLocation(s): Chennai+ View Contact
Keyskills: RCM Quality Monitoring Revenue Cycle Management Quality HIPAA CMS RCM Operations
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