Job description
Job Summary:
The Quality Assurance Manager will be responsible to lead and enhance QA processes within Revenue Cycle Management (RCM), ensuring accuracy, compliance, and continuous improvement.
Key Responsibilities:
- Develop and enforce QA standards and evaluation metrics.
- Lead the QA team to ensure timely audits, compliance, sampling and adherence to quality protocols
- Develop and share quality reports, RCAs, develop and deploy corrective and preventive action plans
- Ensure process meets quality standards consistently
- Provide recommendations on personnel performance and training needs.
- Mentor QA staff and drive a culture of accuracy and improvement.
- Track and report key quality metrics using analytics tools.
- Establish real-time monitoring dashboards and share insights with leadership
- Conduct root cause analysis to identify systemic issues and improve workflow efficiency.
- Publish weekly dashboards and monthly reports for clients
Key Performance Indicators (KPIs):
- Error Detection: Identify 100% of critical errors and 95% of non-critical errors.
- Root Cause Analysis: Complete analysis for all identified errors within five business days.
- Process Improvement: Implement SOP updates for all recurring errors.
- Team Recommendations: Provide actionable feedback within Two business days.
- Error Reduction: Achieve a 50% reduction in recurring errors within 45 days.
- Claim Accuracy Rate: Maintain a 99% claim accuracy rate.
- Timeliness: Complete audits and provide feedback within 48 hours.
Qualifications:
- Bachelors degree.
- 10+ years of experience in RCM or healthcare, with 7+ years in leadership in QA processes.
- Comprehensive knowledge of end-to-end RCM, including billing, coding, and claim management.
- Expertise in QA methodologies, Six Sigma, or Lean principles.
- Proficiency in QA software, RCM systems, and data analytics tools.
- Strong analytical, communication, and problem-solving skills.
- Proven ability to manage and mentor teams effectively.
Role: Quality Manager / Supervisor
Industry Type: BPM / BPO
Department: Quality Assurance
Employment Type: Full Time, Permanent
Role Category: Business Process Quality
EducationUG: Any Graduate