RCM Quality Auditor - Charge Entry
Veradigm (company site, opens in a new tab)PuneOn-siteDirect career pageEst. 5–9 LPA
Posted 16h ago
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Job description
Structured overview of role & requirements
About This Role
- Conduct detailed quality audits of Revenue Cycle Services output including coding, charge entry, payment posting, AR follow-up, and denials to identify and correct errors.
- Provide evidence-based feedback to associates and team leads, and perform root cause analysis to implement corrective actions and prevent recurrent issues.
- Generate audit reports, quality scorecards, and escalations, support client quality communications, and ensure compliance with HIPAA and CMS regulations.
Minimum Requirements
- Work Experience Required: Not explicitly mentioned in the JD
- Must have expertise in auditing coding, charge entry, payment posting, AR and denial management processes.
- In-office role with shift hours Monday to Friday from 7:30 PM to 4:30 AM IST.
- Familiarity with regulatory compliance including HIPAA, CMS rules, and knowledge of CPT, HCPCS, and ICD-10-CM coding updates.
Ideal Candidate Profile
- Experienced in detailed revenue cycle management quality auditing with the ability to apply structured scoring and root cause analysis.
- Comfortable working night shifts and interacting with multiple teams including operations, clients, and associates for quality improvement.
- Skilled in process improvement methods such as Lean, Six Sigma, and interested in automation and AI-assisted audit enhancements.