We are looking for an experienced QA / Senior QA qualified with expertise in Revenue Cycle Management (RCM) – Billing and coding Experince. The candidate will be responsible for monitoring and auditing billing activities, ensuring process compliance, identifying quality gaps, performing Root Cause Analysis (RCA), and driving continuous quality improvement initiatives.
The ideal candidate should possess robust knowledge of medical billing, denial management, insurance follow-up, and quality auditing processes along with excellent analytical and communication skills.
Key Responsibilities
Quality Monitoring & Auditing
- Conduct quality audits for Billing& Coding and documentation.
Evaluate calls based on process adherence, accuracy, compliance, and communication skills.
Ensure adherence to HIPAA regulations and client-specific guidelines.
Monitor agent performance and identify improvement opportunities.
Root Cause Analysis (RCA)
- Perform RCA for recurring errors, denials, and process deviations.
Analyze quality trends and identify process gaps.
Recommend corrective and preventive actions (CAPA).
Collaborate with operations teams to reduce repeat audit failures.
Coaching & Calibration
- Conduct calibration sessions with internal teams and clients.
Support training initiatives and refresher sessions.
Assist in improving overall team quality scores.
Reporting & Analytics
- Prepare daily, weekly, and monthly QA reports.
Track and analyze KPIs such as:
Quality Scores
Error Rates
Denial Trends
Productivity Metrics
Compliance Scores
Share audit insights and improvement plans with management.
Required Skills
Domain Knowledge
- Solid understanding of Ambulance Coding
Revenue Cycle Management (RCM)
Billing and coding (Ambulance coding)
Medical Billing
Experienced in Medicare and Medicaid
QA & RCA Skills
- Quality Analysis
Calibration Process
Root Cause Analysis (RCA)
CAPA Management
📌 Quality Analyst Billing And Coding Chennai
🏢 MedExpert Billing and Consulting
📍 Chennai
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