Revenue Cycle Management Quality Assurance Specialist

2 weeks ago


Vizag, Andhra Pradesh, India 2coms Full time

Job Posting: RCM Quality Assurance Specialist

We are seeking a detail-oriented and analytical RCM Quality Assurance Specialist to join our team at 2coms in Visakhapatnam. 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 and Training: Provide constructive feedback to the RCM team 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.

Qualifications:

  • Education: Bachelor's degree in healthcare administration, finance, business, or a related field.
  • Experience: Minimum of 2 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.


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