Chennai, India

QAE – Quality

Job Code: WSI-Quality-1D

Department: Quality

Function Category: Medical Billing/AR

Group/Grade: 1D

Designation: QAE – Quality

Reporting to: Assistant Manager - Quality

Role Details :

This role is primarily focuses on performing on all billing and AR audits

Area of responsibility :

- Should have the end to end RCM knowledge and be capable to audit Demo, Eligibility, Charge Entry, Payments, Rejections, AR follow up and Denials
- To do Focus and Process audit
- To conduct ‘Ramp up’ meeting with recent agents and provide daily feedback
- Providing advice, ideas and feedback to the team on meeting quality standards
- To take initiative in addressing the global issues
- Should provide daily feedback on the errors with corrective and preventive actions
- To be part of new projects transition for assigned project
- To learn new specialties, process/scopes
- Should perform audits for the minimum 5% or more
- Identifying inefficient or ineffective users and giving constructive feedback for their improvement
- Need to prepare daily and weekly reports
- Need to prepare the Monthly quality reports and conduct monthly meeting with the operation team
- Should identify the process gap’s and provide feedback to the operation team




- Should address focussing and improvement areas for each project
- Should address the top errors which impact the quality score and provide the quality and error trends
- Account Manual questions should be prepared
- Should monitor the agent’s calls and provide the appropriate feedback

Behaviour Competencies / Knowledge required and desirable :

- Reporting Research Results
- Analyzing & Auditing Skill
- Ability to Understand Process and deliver as per client needs
- End to End RCM Knowledge
- Internal Communication
- Attention to Detail
- Administrative Writing Skills

Excellent skills in (desirable) :

- Proficient in MS office/ Typing Skills
- Good Analytical Skill
- Good Communication Skills
- Coaching Skills

Working Relationships/ Span of the role :

- Internal - QAE’s, SQAE, Assistant Manager
- External - Clients (Specify name if any)

Qualifications :

- Graduate in any Stream or equivalent;

Experience (No. of years) :

- Minimum 4 Years of Healthcare Experience

Location: Chennai

Other special requirement: Should have the experience into Quality for the minimum of 1 year

Availability of role: High

Criticality of the role: High

Growth: Horizontal

📌 QAE - Quality (India)
🏢 WorldSource Healthcare
📍 India