QAE - Quality Professional

WorldSource HealthCare; Chennai; On-site; INR 600,000 - 900,000; Full time

Job summary

WorldSource HealthCare in Chennai seeks a Quality Assurance Engineer (QAE) to oversee billing/AR audits and ensure adherence to quality standards. The role focuses on end-to-end RCM audits, process improvements, and providing actionable feedback to agents and operations teams.

The candidate should have 4+ years in healthcare with strong analytical and communication skills, and experience in QA audits and coaching. This is an on-site Chennai role with growth in quality processes.

Qualifications

• Graduate in any stream is required.
• Healthcare QA audit experience preferred.
• End to end RCM knowledge is essential.

Responsibilities

• Audit end-to-end RCM: Demo, Eligibility, Charge Entry, Payments, Rejections, AR follow up and Denials.
• Perform Focus and Process audits.
• Conduct ramp-up meetings with new agents and provide daily feedback.
• Advise, ideas and feedback to meet quality standards.
• Take initiative to address global issues.
• Provide daily feedback on errors with corrective actions.
• Participate in new projects transitions for assigned projects.
• Learn new specialties and processes/scopes.
• Audit minimum of 5% or more.
• Identify inefficient users and give constructive feedback for improvement.
• Prepare daily and weekly reports.
• Prepare monthly quality reports and conduct monthly meetings with operations.
• Identify process gaps and feedback to the operations team.
• Address focus and improvement areas for each project.
• Address top errors impacting quality score and track trends.
• Prepare Account Manual questions.
• Monitor agent calls and provide feedback.

Skills

MS Office

Typing Skills

Analytical Skill

Communication Skills

Coaching Skills

Attention to Detail

Education

Graduate in any Stream

Job description

Job Details

• Department: Quality
• Function Category: Medical Billing/AR
• Group/Grade: 1D
• Designation: QAE - Quality
• Reporting to: Assistant Manager - Quality

Job Summary

This role is primarily focuses on performing on all billing and AR audits

Responsibilities

• Should have the end to end RCM knowledge and be capable to audit Demo, Eligibility, Charge Entry, Payments, Rejections, AR follow up and Denials
• To do Focus and Process audit
• To conduct Ramp up meeting with new agents and provide daily feedback
• Providing advice, ideas and feedback to the team on meeting quality standards
• To take initiative in addressing the global issues
• Should provide daily feedback on the errors with corrective and preventive actions
• To be part of new projects transition for assigned project
• To learn new specialties, process/scopes
• Should perform audits for the minimum 5% or more
• Identifying inefficient or ineffective users and giving constructive feedback for their improvement
• Need to prepare daily and weekly reports
• Need to prepare the Monthly quality reports and conduct monthly meeting with the operation team
• Should identify the process gap s and provide feedback to the operation team
• Should address focussing and improvement areas for each project
• Should address the top errors which impact the quality score and provide the quality and error trends
• Account Manual questions should be prepared
• Should monitor the agent s calls and provide the appropriate feedback

Behavioural Competencies / Knowledge required and desirable

• Reporting Research Results
• Analyzing Auditing Skill
• Ability to Understand Process and deliver as per client needs
• End to End RCM Knowledge
• Internal Communication
• Attention to Detail
• Administrative Writing Skills

Desirable Skills

• Proficient in MS office/ Typing Skills
• Good Analytical Skill
• Good Communication Skills
• Coaching Skills

Working Relationships

• Internal - QAE s, SQAE, Assistant Manager
• External - Clients (Specify name if any)

Qualifications

• Graduate in any Stream or equivalent;

Experience

• Minimum 4 Years of Healthcare Experience

Location: Chennai

Other special requirement: Should have the experience into Quality for the minimum of 1 year

Availability of role: High

Criticality of the role: High

Growth: Horizontal

Disclaimer: This job posting has been aggregated from external source. Role details, content, and availability are subject to change. Applicants are advised to confirm the latest information directly on the company website before applying.