QA/ Process Specialist - RCM
Huron (company site, opens in a new tab)3+ yrsChennaiOn-siteDirect career pageEst. 6–10 LPA
Posted 11h ago
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Job description
Structured overview of role & requirements
About This Role
- Own quality audits of RCM claims, identify billing-rule and process errors, and ensure corrective action before claims are rebilled.
- Coordinate team handling and work allocation, engage with clients and internal/onshore teams, and run calibration sessions to address quality gaps.
- Prepare and present daily, weekly, and monthly audit and RCM metrics; identify trends and recommend process improvements, including through Lean Six Sigma methods.
Minimum Requirements
- Work Experience Required: 3+ years of industry experience, including 2+ years in relevant RCM functions performing quality audits.
- Graduate in any discipline.
- Thorough understanding of RCM functions such as billing, cash posting, credit balance, accounts receivable, denial management, or correspondence review, and metrics such as Days in AR, ageing over 90 days, collections, and bad debt.
- Hands-on reporting experience with proficiency in MS Excel and PowerPoint.
Ideal Candidate Profile
- Has direct experience auditing RCM workflows and applying billing rules or client SOPs to catch errors before claim rebilling.
- Can turn raw audit and operational data into clear metrics, trend analysis, and actionable recommendations for leadership.
- Likely to fit an operations-focused quality role involving team coordination, client interaction, and ongoing process calibration and improvement.