Job Family:
EBO Quality (India)
Travel Required:
None
Clearance Required:
None

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:





• Solid knowledge of US Healthcare Revenue Cycle Management (RCM).

• Strong 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.

• Robust analytical, problem-solving, and attention-to-detail skills.

• Positive communication skills with the ability to provide explicit, constructive feedback.

• Prior experience in a QA or Auditor role.

• Willingness to work on Night Shifts.

• Any UG Degree - Mandatory (Diploma not eligible)

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

📌 Quality Analyst Chennai
🏢 Guidehouse
📍 Chennai