Quality Analyst- Revenue Cycle Management

What You Will Do
- Conduct quality audits on inpatient and observation accounts requiring Notification on Admission (NOA), in line with sampling guidelines.
- Validate accurate submission of notifications through portals, EDI, fax, or calls, and ensure timely initiation of non-clinical authorizations.
- Review documentation accuracy, including reference numbers, authorization numbers, payer timelines, and compliance requirements.
- Perform root cause analysis on identified defects, develop CAPA plans, and track recurring trends such as missed NOAs, delays, and documentation gaps.
- Provide actionable feedback on audit findings, support process clarifications, lead performance improvement discussions, and participate in periodic team reviews.
- Prepare daily, weekly, and monthly quality reports, track SLA and accuracy metrics, and contribute to governance reviews.
- Participate in calibration sessions, refresher initiatives, and training programs to strengthen process quality.

What You Will Need




- Strong knowledge of US Healthcare Revenue Cycle Management (RCM).
- Robust understanding of Authorization and Notification on Admission (NOA) workflows, backed by relevant hands-on experience.
- At least 3 years of experience in US Healthcare RCM.
- Strong analytical, problem-solving, and attention-to-detail skills.
- Good communication skills with the ability to provide clear, constructive feedback.
- Prior experience in a QA or Auditor role.
- Willingness to work on Night Shifts.
- Any UG Degree - Mandatory (Diploma not Eligible)
- Document proofs for Recent Employment.

What Would Be Nice To Have
- Prior experience in Quality Audits / Quality Assurance within US Healthcare RCM
- Exposure to multiple RCM functions (AR, Denials, Charge Entry, Payment Posting)
- Experience in trend analysis, data interpretation, and quality reporting
- Familiarity with audit tools, scorecards, and quality metrics
- Knowledge of HIPAA compliance an

📌 Quality Analyst-AR- Voice Process- Revenue Cycle Management (Hyderabad)
🏢 Guidehouse
📍 Hyderabad