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Job Description
Structured overview of role & requirementsAbout This Role
Lead and manage RCM QA team including audits, work allocation, and client interactions.
Generate and distribute RCM metrics and audit reports to leadership, analyzing data and presenting actionable insights.
Implement and improve processes using Lean Six Sigma methodologies to ensure claims processing accuracy and compliance.
Minimum Requirements
3+ years industry experience with 2+ years in RCM quality audits.
Graduate degree in any discipline.
Proficiency in MS Excel and PowerPoint for reporting and data analysis.
Strong understanding of RCM processes (Billing, Cash Posting, Credit Balance, AR, Denial Management) and metrics (Days in AR, Aging, Collections).
Ideal Candidate Profile
Experienced in managing QA teams focused on RCM functions within healthcare or medical billing domains.
Adept at data analysis and reporting with ability to present findings to leadership clearly and convincingly.
Detail-oriented with practical expertise in applying Lean Six Sigma or quality improvement methodologies to RCM processes.