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Niche RCM QA skillset and seniority reduce applicant density despite metro location and recognizable employer.
RCM quality expertise, payer rules, and HIPAA compliance make skills poorly transferable across industries.
Explicit 9-11 years, mandatory QA tenure and HIPAA/CMS requirements indicate high shortlisting strictness.
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Lead and manage quality assurance across all Revenue Cycle Management functions including coding, billing, AR follow-up, denial management, and payment posting.
Own quality benchmarks, audit strategy, scorecards, and compliance with CMS and payer guidelines while driving continuous improvement initiatives.
Manage a team of 20+ QA analysts with responsibility for training, performance management, root cause analysis, and client quality issue resolution.
9-11 years of experience in RCM operations with at least 7 years in Quality Analyst, Senior QA, or Team Lead roles.
Proven experience managing quality teams of 10+ members in healthcare BPO/KPO environments.
Graduate degree in any discipline; certification in Medical Billing/Coding (CPC, CRC, CPMA) preferable.
In-depth knowledge of billing, payment posting, AR follow-up, denial management, HIPAA, PHI, CMS guidelines, and payer-specific compliance.
Experienced leader capable of both hands-on audit governance and strategic quality improvement across RCM operations.
Strong expertise in healthcare RCM compliance, quality metrics, process improvement, and stakeholder management.
Comfortable managing large teams in fast-paced, client-focused healthcare BPO/KPO environments with data-driven decision making.