HealthRecon Connect provides technology-enabled Revenue Cycle Management (RCM) solutions to US healthcare providers. We leverage over 30 years of deep domain expertise, cutting-edge analytics as well as machine learning, Artificial Intelligence and Automated workflows to help improve cashflow, patient outcomes and enable peace of mind for our clients.

At HealthRecon Connect (HRC), we hold ourselves accountable for setting and maintaining high standards. Day after day, we passionately strive for high achievement; for customer delight and thrive on the challenge of high expectations and commitment to excel.

We are seeking a highly skilled and experienced Healthcare RCM Professional to join our dynamic team. .

Role & responsibilities

Strategic Mandate:

- Architect and own the end-to-end quality framework aligned with organizational strategy and client SLAs.
- Lead the QA functions evolution from a reactive audit model to a proactive, data-driven quality intelligence engine.
- Champion automation and AI adoption within QA identifying use cases, piloting tools, and scaling proven solutions across processes.
- Serve as the internal subject-matter expert bridging quality insights with operational improvement, technology enablement, and workforce capability.
- Build and sustain a quality-first culture rooted in accountability, transparency, and continuous learning.

Quality Strategy:

- Design, implement, and continuously refine the enterprise QA framework for assigned RCM processes (e.g., Billing, Coding, AR Follow-Up, Denials, Payment Posting).
- Develop risk-based sampling methodologies that intelligently prioritize high-impact audit areas over blanket volume-based checks.
- Establish quality governance structures including calibration cadences, error taxonomy, root-cause classification, and trend reporting.




- Align QA standards with US regulatory requirements including HIPAA, CMS guidelines, and applicable payer-specific policies.
- Review, approve, and maintain SOPs and quality policies; ensure these are operationalized not just documented.

Continuous Improvement:

- Lead root-cause analysis (RCA) for recurring error trends and hold cross-functional teams accountable for corrective actions and preventive measures (CAPA).
- Monitor the impact of improvement actions through before/after metrics and sustain gains through updated controls and checkpoints.

Automation & AI Enablement

- Identify repetitive, rules-based QA tasks suitable for automation (e.g., automated audit queues, real-time claim-level edits, dashboard alerting) and build the business case for investment.
- Collaborate with Technology, Analytics, and Vendor teams to design, test, and deploy AI-assisted quality tools including NLP-based coding audit support, predictive denial analytics, and intelligent audit sampling
- Track industry developments in RCM AI/automation (payer portals, clearinghouse integrations, AI coding assistants) and proactively recommend adoption pathways

Performance Management & Reporting

- Own QA reporting and management information (MI): design dashboards that provide actionable insight to Ops, Leadership, and Client stakeholders not just numbers.
- Monitor daily, weekly,



and monthly QA production trackers; ensure QC TAT commitments are met without compromising accuracy.

Leadership & Strategic Skills

- Proven ability to think and operate at a strategic level translating organizational goals into QA roadmaps and execution plans.
- Robust people leadership skills: inspires accountability, coaches for growth, and manages performance with candor and fairness.
- Change management capability: able to gain buy-in for new methodologies, tools, and ways of working across diverse teams.

Qualifications & Certifications:

- Bachelors degree required; discipline in Healthcare Management, Business Administration, or related field preferred.
- Professional certification in one or more of the following is strongly preferred: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Revenue Cycle Professional (CRCP), Fellow of the American Academy of Professional Coders (AAPC), or equivalent from a recognized body such as AAPC or AHIMA.
- Certification or training in Lean, Six Sigma (Green Belt or above), or other continuous improvement frameworks is a strong advantage.
- Formal training or certification in AI/automation tools applied in healthcare or BPO contexts is desirable.

Preferred candidate profile

- 8 to 10 years in RCM Industry
- 4 to5 years in a QA/Quality Audit function within RCM
- 3+ years leading a QA team as a people manager and strategy driver
- Hands-on operational experience across multiple RCM functions (not solely QA) strongly preferred
- Demonstrated involvement in or leadership of a CI, automation, or technology-enablement initiative

Shift : 2p.m to 11p.m IST

Working days: Monday to Friday

Week off:Saturday & Sunday

Interested candidates kindly send us your udpated resume to [email protected]

📌 We are hiring Manager - Quality Assurance from RCM Industry (India)
🏢 HealthRecon Connect
📍 India