Senior Quality Assurance Lead
2 days ago
We are seeking an experienced professional to lead quality assurance in our medical billing operations. The ideal candidate will ensure process excellence, compliance with payer regulations, and continuous improvement across Revenue Cycle Management (RCM) functions.
About the Role:
- Establish and monitor quality standards across Medical Billing, AR follow-up, and denial management.
- Conduct regular audits, reviews, and root cause analyses to identify gaps and implement corrective actions.
- Collaborate with operations, training, and compliance teams to drive process improvements.
- Develop and track quality metrics (accuracy, compliance scores, productivity impact, SLA adherence).
- Provide feedback, coaching, and training to team members to enhance performance.
- Ensure adherence to HIPAA guidelines, payer policies, and regulatory requirements.
- Partner with clients and leadership to present quality performance reports and improvement plans.
Requirements:
- 8-12 years of experience in RCM / medical billing quality function.
- Strong understanding of quality frameworks, audit methodologies, and US healthcare regulations.
- Proven track record in driving quality initiatives and achieving measurable improvements.
- Excellent communication, analytical, and stakeholder management skills.
- Experience in Six Sigma / Lean methodologies is a plus.
- Experience in handling quality analyst team (Medical Billing).
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