US Healthcare experience is mandatory The role focuses on Quality Assurance for Revenue Cycle Management (RCM) in the US Healthcare domain.The QA team will evaluate whether Medical billing, claims, payments, denials and other RCM activities are being performed accurately and completely, while ensuring adherence to payer requirements, SOPs, workflow guidelines and compliance standards.
Responsibilities:
- Provides support for all quality reviews and assessments of revenue cycle processes performed by international vendors
- Ensures accuracy of assessments and operations in the Global QA Tool
- Assists in ensuring vendors adhere to process and procedure
- Assesses quality and operational metrics of the Global Quality Assurance Team
- Review and trend account issues related to quality and SLA compliance to provide feedback to Global Operations Manager
- Provides operational support to the Global Operations Manager
- Educates current team members on vendor quality processes
- Demonstrates and applies expert level of knowledge of revenue cycle processes and concepts
- Maintains up-to-date knowledge of the business processes assigned to the international vendors
- Ensures safe, ergonomic and confidentiality compliant practices are being followed within the work environment
- Practice and adhere to the Code of Conduct philosophy and Mission and Value Statement
Essential Capabilities:
- Minimum 9 Years of experience in RCM
- Mandatory team handling and people management experience
- Strong experience in Quality Assurance and Quality Checks
- Strong knowledge of hospital revenue cycle
- Excellent communication skills to communicate clearly and concisely, verbally and in writing