QA/ Process Specialist - RCM

Description

JOB DETAILS:
• Experience in handling a team / group of 15 to 20 FTEs
• Thorough understanding of RCM processes like Billing, Cash Posting, Credit Balance, Accounts Receivables, Denial Management & Correspondence review
• Very good understanding of RCM metrics like Days in AR, Ageing above 90 days, Collections and bad debt
• Periodically review teams performance and recommend performance improvement plan wherever required
• Hands on in preparing daily, weekly & monthly operational metrics reports from the Practice Management/Billing System and workflow tool using MS-Excel
• Identify trends and patterns from the generated reports and initiate action plan to resolve the AR issues
• Responsible for work allocation / distribution to the team and monitor the team work
• Create and maintain daily operational scorecards to track and report KPI’s; assist in volume forecast and capacity planning as required
• Generate and distribute management reports in accurate and timely manner
• Perform data analysis for generating reports on periodic basis including adhocs
• Establish a strong relationship with Team Managers by demonstrating the gaps, trends & patterns identified during the data/report compilation
• Suggest ways of improving the process using Lean Six Sigma methodology and suggesting automation of repetitive processes
• Able to interact with the client effectively
• Willing to work in night shift / US timings

• Epic

QUALIFICATIONS:

• 5+ years of industry experience
• 3+ year Experience in relevant billing functions is a must
• Proficient in MS Excel and creating Excel macros
• Strong ability to analyze raw data, draw conclusions and develop actionable recommendations
• Ability to handle multiple tasks of reporting simultaneously
• Ability to adapt quickly to new and changing technical environments as well as strong analytical, problem solving and quantitative abilities.
Solid verbal and written communication skills are required.


Education/Certifications:
• Graduate in any discipline.