Job Description Summary:
The Associate Manager – Quality, RCM is responsible for leading, monitoring, and continuously improving the quality assurance function within Revenue Cycle Management operations. This is a people-plus-process leadership role that combines hands-on audit governance with team management, client engagement, and strategic quality improvement.
You will serve as the primary quality ambassador between operations, clients, and senior leadership — ensuring compliance with payer guidelines, HIPAA regulations, and internal SOPs while driving performance excellence across all QA analysts. You will own the quality scorecard, shape audit strategy, and build a culture of accountability and continuous learning within your team.

KEY RESPONSIBILITIES

Quality Oversight & Governance
Own and enforce quality benchmarks across all RCM functions — coding, billing, AR follow-up, denial management, and payment posting
Establish and maintain quality control checkpoints at each stage of the revenue cycle workflow
Ensure 100% alignment with CMS guidelines,



payer-specific rules, client contractual obligations, and HIPAA/PHI regulations
Define and manage the monthly/quarterly audit plan, sampling strategies, and QA frameworks

Audit Management & Root Cause Analysis
Oversee daily, weekly, and monthly transaction audits and calibration sessions across all RCM verticals
Drive root cause analysis (RCA) for all identified errors and ensure actionable corrective plans are documented and tracked
Maintain comprehensive audit trails and error logs for regulatory and client review
Identify recurring defect patterns and escalate critical findings to operations leadership with data-backed reports

Team Leadership & People Management
Lead, mentor, coach, and manage a team of 20+ QA analysts, ensuring equitable workload distribution and skilled growth
Facilitate regular team huddles, one-on-one feedback sessions, and calibration meetings to promote a quality-

📌 Rcm Associate Manager Pune
🏢 Pune
📍 Pune