QA/ Process Specialist - RCM
Core
Perform quality audits and process management for Revenue Cycle Management (RCM) operations in healthcare, ensuring billing compliance and generating metrics reports.
Role type
Associate RCM QA/Process Specialist
Builds
RCM metrics reports and audit findings for healthcare clients
Domain
Healthcare / Revenue Cycle Management
Deliverable
dashboards & analysis
Required skills
RCM process knowledge (Billing, Cash Posting, AR, Denial Management), RCM metrics analysis, Quality auditing, Lean Six Sigma, MS Excel, MS PowerPoint, Data analysis
Preferred skills
Lean Six Sigma certification
Responsibilities
Perform quality checks/audits on processed claims, ensure compliance with billing rules, generate and distribute RCM metrics reports, analyze data to identify trends and gaps, present findings to leadership, suggest process improvements, conduct calibration sessions, develop quality documentation
Seniority
Associate, hands-on IC
