Assistant Manager- Qaulity

MedExpert Billing; Chennai District; On-site; INR 900,000 - 1,200,000; Full time

Job summary

MedExpert Billing is looking for an Assistant Manager – Quality to enhance quality assurance across RCM functions. This role involves managing audits, mentoring team members, and ensuring compliance with regulations.

The ideal candidate will have over 8 years of RCM experience with a strong background in quality processes, leadership skills, and the ability to communicate effectively with clients. Join us to drive operational excellence!

Qualifications

• Minimum 8 years in RCM with 3+ years in quality leadership.
• Strong understanding of RCM processes.
• Expertise in medical coding, billing, and denial management.

Responsibilities

• Oversee quality assurance processes across RCM functions.
• Conduct audits for compliance and productivity.
• Mentor QA analysts and set performance goals.
• Ensure adherence to healthcare regulations.
• Act as a SPOC for client interactions.

Skills

Leadership

Analytical skills

Communication

Problem-solving

Quality tools knowledge

Education

Any graduate

Job description

Job Title: Assistant Manager –Quality (RCM)

Job Summary

The Quality Assistant Manager is responsible for overseeing and enhancing quality assurance processes across all RCM functions, billing, AR follow-up, and denial management. This role ensures compliance with client requirements, regulatory standards, and internal benchmarks while driving continuous improvement and operational excellence

Key Responsibilities

1. Quality Assurance s Auditing

• Develop and implement quality assurance frameworks across RCM processes
• Conduct regular audits of coding, billing, and AR processes • Ensure adherence to payer guidelines, client SOPs, and regulatory standards (HIPAA, CMS, etc.)
• Monitor accuracy, productivity, and compliance metrics

2. Process Improvement

• Identify quality gaps and root causes of errors
• Collaborate with operations teams to reduce denials and improve first-pass yield
• Standardize best practices across teams

3. Team Management

• Lead and mentor QA analysts and auditors
• Set performance goals and KPIs for the quality team •
• Conduct regular training and calibration sessions
• Ensure consistency in audit scoring and feedback
• Prepare and present quality dashboards and reports to leadership and clients
• Track KPIs such as accuracy rates, denial rates, turnaround time, and rework
• Provide actionable insights to improve operational performance

5. Compliance s Risk Management

• Ensure compliance with healthcare regulations (HIPAA, ICD-10, CPT, HCPCS)
• Support external audits and client reviews
• Mitigate risks related to billing errors and revenue leakage

6. Client Interaction

• Act as a quality SPOC for clients
• Participate in client calls and business reviews
• Address client escalations related to quality issues
• Align quality goals with client expectations

Required Qualifications

• Any graduate
• 8–12 years of experience in RCM with at least 3+ years in a quality leadership role
• Strong knowledge of end-to-end RCM processes
• Expertise in medical coding, billing, and denial management
• Analytical and problem-solving skills
• Leadership and stakeholder management
• Excellent communication and presentation skills
• Familiarity with quality tools and methodologies