
Senior Medical Billing Quality Specialist
4 days ago
No. Positions: 4, Industry: Healthcare / Revenue Cycle Management (RCM)
- We are seeking a seasoned quality professional to oversee and monitor quality standards across Medical Billing, AR follow-up, and denial management.
- The successful candidate will conduct regular audits, reviews and root cause analyses to identify gaps and implement corrective actions.
- This role requires collaboration with operations, training and compliance teams to drive process improvements.
- Key responsibilities include developing and tracking quality metrics (accuracy, compliance scores, productivity impact, SLA adherence).
- As a quality assurance manager, you will provide feedback, coaching, and training to team members to enhance performance.
- Additionally, the incumbent will ensure adherence to HIPAA guidelines, payer policies, and regulatory requirements.
- Partnering with clients and leadership to present quality performance reports and improvement plans is also essential for this role.
Desired Profile:
- 8–12 years of experience in RCM / medical billing quality function.
- A strong understanding of quality frameworks, audit methodologies, and US healthcare regulations is required.
- The ideal candidate has a proven track record in driving quality initiatives and achieving measurable improvements.
- Excellent communication, analytical and stakeholder management skills are necessary for success in this role.
- Experience in Six Sigma / Lean methodologies is a plus.
- Previous experience handling quality analyst team (Medical Billing) is also desirable.
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