RCM Quality Auditor
Veradigm (company site, opens in a new tab)PuneOn-siteDirect career pageEst. 4–7 LPA
Posted 16h ago
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Job description
Structured overview of role & requirements
About This Role
- Conduct detailed audits on Revenue Cycle Services work including coding, claims, payment posting, AR follow-up, and denials to identify and prevent errors.
- Provide evidence-based feedback to associates and team leads within 24-48 hours to enable corrective actions and track closure of issues.
- Prepare and maintain audit records, reports, and quality scorecards; escalate critical errors impacting revenue or compliance immediately.
Minimum Requirements
- Experience in auditing or quality assurance within Revenue Cycle Management or healthcare billing is mandatory (exact years not specified).
- Must be able to work night shift: Monday to Friday 7:30 PM IST to 4:30 AM IST.
- Knowledge of medical coding systems (CPT, HCPCS, ICD-10-CM) and healthcare reimbursement processes is essential.
- Work Experience Required: Not explicitly mentioned in the JD.
Ideal Candidate Profile
- Detail-oriented professional with experience in auditing various RCM components including coding, payment posting, denials, and AR follow-up.
- Comfortable with providing structured feedback and root cause analysis to improve team quality and compliance.
- Familiar with compliance standards (HIPAA, CMS rules) and willing to engage in continuous process improvement including automation and Lean methodologies.