Senior Quality Assurance Manager - Revenue Cycle Management - Work From
Senior Quality Assurance Manager - Revenue Cycle Management - Work From
Posted on :
27-01-2025
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1 Vacancy
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Job Description
Job Title: Senior Quality Assurance Manager Revenue Cycle Management (RCM) Work From
Job Location: Bengaluru Karnataka India
Job Location Type: Remote
Job Contract Type: Fulltime
Job Seniority Level: MidSenior level
ClinicMind is a leading provider of comprehensive healthcare practice management software and service platform for a full patient care cycle. We are seeking an experienced and analytical Senior Quality Assurance Manager to lead our Quality Assurance (QA) teams in monitoring evaluating and improving the performance of our Revenue Cycle Management (RCM) operations. This role is focused on identifying and addressing errors analyzing root causes recommending process improvements and supporting personnel optimization to ensure operational excellence. The ideal candidate will combine a deep understanding of RCM processes with an ability to drive highquality deliverables and measurable improvements.
Key Responsibilities
Root Cause Analysis and Process Improvement
Key Responsibilities
Root Cause Analysis and Process Improvement
- Quality Assurance Operations
- Oversee QA teams responsible for identifying errors made by RCM teams during insurance claim processing followup and resolution.
- Develop and enforce QA standards and evaluation metrics to ensure consistent accurate and thorough discovery of errors.
- Regularly audit RCM processes and outputs providing detailed reports on findings to leadership.
- Conduct indepth root cause analyses for identified errors to uncover systemic issues or gaps in training technology or processes.
- Collaborate with stakeholders to propose updates to Standard Operating Procedures (SOPs) to eliminate recurring errors and improve workflow efficiency.
- Monitor the effectiveness of implemented changes ensuring sustainable improvements over time.
- Provide detailed recommendations to RCM managers regarding personnel performance identifying strengths and areas for development among team members engaged in claims followup.
- Partner with HR and training teams to address identified skill gaps through targeted training programs.
- Facilitate regular feedback loops between QA and RCM teams to promote accountability and knowledgesharing.
- Manage and mentor QA staff fostering a culture of accuracy objectivity and continuous improvement.
- Conduct regular team performance reviews and provide guidance to ensure highquality deliverables.
- Develop and deliver training sessions on quality standards and evolving RCM best practices.
- Utilize analytics tools and QA software to track and report key quality metrics.
- Identify trends in errors and develop proactive strategies to prevent them.
- Establish a dashboard for realtime monitoring of QA performance and share insights with leadership.
- Error Detection:
- Discovery of 100% of critical errors and 95% of noncritical errors across all RCM processes.
- Root Cause Analysis:
- Completion of comprehensive root cause analyses for 100% of identified errors within five business days.
- Process Improvement Implementation:
- SOP updates proposed and implemented for 100% of recurring errors with measurable impact.
- Team Recommendations:
- Actionable personnel recommendations provided to managers within five business days of review completion.
- Error Recurrence Reduction:
- Achieve a 50% reduction in recurring errors within the first 90 days of process improvement implementation.
- Claim Accuracy Rate:
- Maintain a 99% claim accuracy rate across all teams audited.
- Timeliness:
- QA audits completed and feedback provided to RCM teams within 48 hours of claim processing.
- Bachelor’s degree in healthcare administration business administration or a related field. Master’s degree preferred.
- Minimum of 8 years of experience in RCM or healthcare quality assurance roles with proven leadership in QA processes.
- Expertise in healthcare billing coding reimbursement processes and claim management workflows.
- Strong understanding of QA methodologies and process improvement techniques such as Six Sigma or Lean principles.
- Proficiency in QA software RCM systems and data analytics tools.
- Exceptional analytical communication and problemsolving skills.
- Proven ability to manage and mentor teams effectively.
- Must have stable internet connection minimum of 5 MBPS
- Must have a mobile data plan as a backup
- Must be in a quiet environment
- Must be comfortable working the US business hours
- Must own a PC with at least 16 GB of memory
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Employment Type
Full Time
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