Quality Expert

2 weeks ago


Hyderabad, Telangana, India IKS Health Full time
Minimum

years of experience in RCM domain in US Health, preferably in Quality Auditor/Expert capacity in Accounts Receivables.
Expertise in medical billing end to end RCMStrong knowledge on various denials and remark codes and able to take immediate action to resolve them and follow up on the claims for collection of paymentMonitor and analyze RCM process errorsAudit error corrections both short- and long-termQuantify error rates and their trends individually, by team, by client, and by client poolAnalyze the errors to build training materials and testsCreate automation solutions to reduce error ratesShould be able to resolve billing issues that have resulted in delay in paymentResponsible for call/data quality monitoringProvide feedback to agents using the prescribed feedback modelMentoring and coaching agents on process-level issuesMonitor adherence to compliance procedures and processesResponsible for reporting program-level quality scores to the process ownersResponsible for conducting calibration and performance review calls in terms of quality with clients as well as the internal teamConduct refresher training on the basis of the errors identifiedPerform weekly analysis aiming at improving SLAPerform brainstorming and root cause analysis to analyze data and provide tips or suggestions to the operation/management teamIdentify and highlight potential risk areas and recommend preventive actionMaintaining a robust monitoring system to ensure key program metrics are adhered to and the required level of quality is maintained across the board

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