Quality Expert

2 weeks ago

Navi Mumbai, Maharashtra, India IKS HEALTH Full time ₹ 9,00,000 - ₹ 12,00,000 per year

******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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