Role & responsibilities

- Perform quality audits across RCM functions including Eligibility Verification, Prior Authorization, Charge Entry, Medical Coding, Payment Posting, AR Follow-up, and Denial Management.
- Evaluate transactions and processes for accuracy, compliance, and adherence to client-specific guidelines.
- Provide detailed audit feedback, coaching insights, and corrective action recommendations to operational teams.
- Analyze quality trends, identify root causes of errors, and implement preventive measures.
- Prepare and present quality reports, scorecards, and performance dashboards.
- Conduct calibration sessions with Operations and Training teams to ensure audit consistency.
- Ensure compliance with HIPAA, payer regulations, and organizational policies.




- Support process improvement initiatives and quality enhancement programs.

Preferred candidate profile

- Graduate in any discipline.
- 5+ years of experience in Quality Assurance within US Healthcare RCM.
- Solid expertise in AR Follow-up, Denial Management, Medical Billing, Payment Posting, and related RCM processes.
- Experience in quality auditing, root cause analysis, and process improvement.
- Excellent analytical, reporting, and communication skills.
- Advanced proficiency in MS Excel and quality reporting tools.
- Thorough understanding of HIPAA, payer guidelines, and healthcare compliance standards.

📌 Walk-in || Quality Analyst (Chennai)
🏢 ONCOSPARK
📍 Chennai