Job Title: Assistant Manager –Quality (RCM)

Job Summary

The Quality Assistant Manager is responsible for overseeing and enhancing quality assurance processes across all RCM functions, billing, AR follow-up, and denial management. This role ensures compliance with client requirements, regulatory standards, and internal benchmarks while driving continuous improvement and operational excellence

Key Responsibilities

1. Quality Assurance s Auditing

- Develop and implement quality assurance frameworks across RCM processes
- Conduct regular audits of coding, billing, and AR processes • Ensure adherence to payer guidelines, client SOPs, and regulatory standards (HIPAA, CMS, etc.)
- Monitor accuracy, productivity, and compliance metrics

2. Process Improvement

- Identify quality gaps and root causes of errors
- Drive continuous improvement initiatives (Lean, Six Sigma, etc.)
- Collaborate with operations teams to reduce denials and improve first-pass yield
- Standardize best practices across teams

3. Team Management

- Lead and mentor QA analysts and auditors
- Set performance goals and KPIs for the quality team •
- Conduct regular training and calibration sessions
- Ensure consistency in audit scoring and feedback

4. Reporting s Analytics





- Prepare and present quality dashboards and reports to leadership and clients
- Track KPIs such as accuracy rates, denial rates, turnaround time, and rework
- Provide actionable insights to improve operational performance

5. Compliance s Risk Management

- Ensure compliance with healthcare regulations (HIPAA, ICD-10, CPT, HCPCS)
- Conduct internal compliance audits
- Support external audits and client reviews
- Mitigate risks related to billing errors and revenue leakage

6. Client Interaction

- Act as a quality SPOC for clients
- Participate in client calls and business reviews
- Address client escalations related to quality issues
Align quality goals with client expectations

Required Qualifications

- Any graduate
8–12 years of experience in RCM with at least 3+ years in a quality leadership role

Key Skills s Competencies

- Robust knowledge of end-to-end RCM processes
- Expertise in medical coding, billing, and denial management
- Analytical and problem-solving skills
- Leadership and stakeholder management
- Excellent communication and presentation skills
- Familiarity with quality tools and methodologies

📌 Assistant Manager- Qaulity (India)
🏢 MedExpert Billing and Consulting
📍 India