Medical Billing Quality Assurance Expert

2 days ago

Salem, Tamil Nadu, India beBeeQuality Full time ₹ 9,00,000 - ₹ 15,00,000
About the Role

We are seeking a seasoned Quality Assurance Lead to oversee quality assurance initiatives in our medical billing operations.

  • The ideal candidate will drive process excellence, ensure compliance with payer regulations, and spearhead continuous improvement across RCM functions.
  • This includes establishing and monitoring quality standards across Medical Billing, AR follow-up, and denial management.
  • The role also involves conducting regular audits, reviews, and root cause analyses to identify gaps and implement corrective actions.
  • Additionally, the Quality Assurance Lead will collaborate with operations, training, and compliance teams to drive process improvements.
  • They will develop and track quality metrics (accuracy, compliance scores, productivity impact, SLA adherence).
  • The successful candidate will provide feedback, coaching, and training to team members to enhance performance.
  • Furthermore, they will ensure adherence to HIPAA guidelines, payer policies, and regulatory requirements.
  • The Quality Assurance Lead will partner with clients and leadership to present quality performance reports and improvement plans.
Desired Profile
  • 8-12 years of experience in RCM/medical billing quality function is required.
  • A strong understanding of quality frameworks, audit methodologies, and US healthcare regulations is essential.
  • The successful candidate will have a proven track record in driving quality initiatives and achieving measurable improvements.
  • Excellent communication, analytical, and stakeholder management skills are necessary.
  • Experience in Six Sigma/Learn methodologies is a plus.
  • Previous experience in handling quality analyst teams (Medical Billing) is desired.
Key Responsibilities

The role includes key responsibilities such as ensuring process excellence, compliance with payer regulations, conducting regular audits and reviews, and collaborating with various teams to drive process improvements.

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