We are looking for an RCM QA Specialist to join our team. This role is essential to our mission, ensuring that our Revenue Cycle Management processes are accurate, compliant, and of the highest quality. You will be a guardian of our standards, auditing transactions and identifying opportunities for continuous improvement to ensure we are delivering the best possible outcomes for our clients.
What You ll Do
As an individual contributor, you will focus on high-impact quality assurance activities that drive operational excellence:
- Auditing Compliance : Conduct detailed audits of transactions and call reviews to ensure strict adherence to company policies, regulatory guidelines, and payer requirements.
- Feedback Coaching : Provide direct, constructive verbal feedback during 1:1 sessions or team huddles to help colleagues improve and align with quality standards.
- Discrepancy Documentation : Diligently identify and document errors or non-compliant practices using standard protocols.
- Process Improvement Innovation: Participate in FMEA (Failure Mode and Effects Analysis) sessions to identify root causes and propose data-driven improvement suggestions.
- Collaboration:
Partner with operations teams during calibration sessions to clarify audit guidelines and share knowledge.
- Reporting: Create daily, weekly, and monthly audit reports to provide visibility into quality trends for internal teams.
- Dispute Resolution: Respond to audit rebuttals in a timely manner, escalating complex issues to senior leadership when necessary.
What You Bring
- Education: A Bachelor s degree in any discipline is mandatory.
- 5+ years of total RCM experience is preferred, with at least 1 year specifically in an auditing role.
- Experience: A minimum of 4 years of experience in Revenue Cycle Management (RCM) is required.
- Technical Skills: Proficiency in Basic Excel is required for data tracking and reporting.
- Mindset: Accountability: You take ownership of outcomes and hold yourself to high standards.
- Communication: You can clearly express ideas and build trust across multiple sub-business units.
- Customer Focus: You are dedicated to building positive relationships and delivering solutions that delight our customers.
- Agility: You embrace change and see it as an chance for growth.
Disclaimer : This job posting has been aggregated from external source. Role details, content, and availability are subject to change. Applicants are advised to confirm the latest information directly on the company website before applying.