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2 days ago
We are seeking an accomplished Quality Assurance Manager to spearhead quality assurance initiatives in medical billing operations.
About the RoleThe ideal candidate will be responsible for ensuring process excellence, compliance with payer regulations, and continuous improvement across Revenue Cycle Management functions.
Key Responsibilities:- Develop and monitor quality standards across Medical Billing, AR follow-up, and denial management.
- Collaborate with operations, training, and compliance teams to drive process improvements.
- Establish and track quality metrics (accuracy, compliance scores, productivity impact, SLA adherence).
- Provide coaching, training, and feedback 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.
To excel in this role, you will need:
- 8–12 years of experience in RCM / medical billing quality function.
- A strong understanding of quality frameworks, audit methodologies, and US healthcare regulations.
- A 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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