
Quality Expert
2 weeks ago
******READ POST BEFORE APPLYING******
Interview Process:
1- Online Assessment (50 MCQ's based on RCM knowledge and Aptitude)
2- Virtual Interview
Weekends Off
Skills Required :
- Minimum 3+ years of experience in RCM domain in US Health, preferably in Quality
Auditor/Expert capacity in Eligibility Verification OR Accounts Receivable Report OR Medical Billing
- Expertise in medical billing end to end RCM
- Strong knowledge on various denials and remark codes and able to take immediate action to
resolve them and follow up on the claims for collection of payment
- Monitor and analyze RCM process errors
- Audit error corrections both short- and long-term
- Quantify error rates and their trends individually, by team, by client, and by client pool
- Analyze the errors to build training materials and tests
- Create automation solutions to reduce error rates
- Should be able to resolve billing issues that have resulted in delay in payment
- Responsible for call/data quality monitoring
- Provide feedback to agents using the prescribed feedback model
- Mentoring and coaching agents on process-level issues
- Monitor adherence to compliance procedures and processes
- Responsible for reporting program-level quality scores to the process owners
- Responsible for conducting calibration and performance review calls in terms of quality with
clients as well as the internal team
- Conduct refresher training on the basis of the errors identified
- Perform weekly analysis aiming at improving SLA
- Perform brainstorming and root cause analysis to analyze data and provide tips or
suggestions to the operation/management team
- Identify and highlight potential risk areas and recommend preventive action
- Maintaining a robust monitoring system to ensure key program metrics are adhered to and
the required level of quality is maintained across the board
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