Quality Analyst

Guidehouse Inc.; Hyderabad; On-site; INR 600,000 - 800,000; Full time

Benefits offered by this job

Competitive compensation

Comprehensive benefits

Learning & development programs

Job summary

Guidehouse India is hiring for a Quality Auditor in US Healthcare RCM. The role focuses on NOA audits, accurate submission validation, and ensuring timely non-clinical authorizations.

You will review reference and authorization numbers, perform root cause analysis, and drive CAPA plans while contributing to governance reviews. The ideal candidate has 3+ years in US Healthcare RCM, strong analytical skills, and willingness to work night shifts.

Qualifications

• At least 3 years of experience in US Healthcare RCM.
• Hands-on experience with Authorization and NOA workflows.
• Strong analytical, problem-solving, and attention-to-detail skills.
• Good communication with ability to provide constructive feedback.
• Prior experience in a QA or Auditor role.
• Willingness to work night shifts.
• UG degree is mandatory (Diploma not eligible).

Responsibilities

• Conduct quality audits on inpatient and observation NOA accounts.
• Validate accurate submission of notifications through portals, EDI, fax, or calls.
• Review documentation accuracy: reference numbers, authorization numbers, payer timelines.
• Perform root cause analysis and develop CAPA plans; track recurring trends.
• Provide actionable feedback on audit findings and support process clarifications.
• Prepare daily, weekly, and monthly quality reports and track SLA metrics.
• Participate in calibration sessions, refresher initiatives, and training programs to strengthen quality.

Skills

US Healthcare RCM

NOA workflows

Quality audits

QA auditing

Education

UG degree required

Tools

Audit tools

Job description

What You Will Do

• Conduct quality audits on inpatient and observation accounts requiring Notification on Admission (NOA), in line with sampling guidelines.
• Validate accurate submission of notifications through portals, EDI, fax, or calls, and ensure timely initiation of non-clinical authorizations.
• Review documentation accuracy, including reference numbers, authorization numbers, payer timelines, and compliance requirements.
• Perform root cause analysis on identified defects, develop CAPA plans, and track recurring trends such as missed NOAs, delays, and documentation gaps.
• Provide actionable feedback on audit findings, support process clarifications, lead performance improvement discussions, and participate in periodic team reviews.
• Prepare daily, weekly, and monthly quality reports, track SLA and accuracy metrics, and contribute to governance reviews.
• Participate in calibration sessions, refresher initiatives, and training programs to strengthen process quality.

What You Will Need

• Strong knowledge of US Healthcare Revenue Cycle Management (RCM).
• Strong understanding of Authorization and Notification on Admission (NOA) workflows, backed by relevant hands-on experience.
• At least 3 years of experience in US Healthcare RCM.
• Strong analytical, problem-solving, and attention-to-detail skills.
• Good communication skills with the ability to provide clear, constructive feedback.
• Prior experience in a QA or Auditor role.
• Willingness to work on Night Shifts.
• Any UG Degree - Mandatory (Diploma not eligible)

What Would Be Nice To Have

• Prior experience in Quality Audits / Quality Assurance within US Healthcare RCM
• Exposure to multiple RCM functions (AR, Denials, Charge Entry, Payment Posting)
• Experience in trend analysis, data interpretation, and quality reporting
• Familiarity with audit tools, scorecards, and quality metrics
• Knowledge of HIPAA compliance and quality standards
• Ability to mentor team members and support performance improvement initiatives

About Guidehouse India

At Guidehouse India, we're redefining what's possible by creating opportunities that change lives. Guidehouse is a global professional services firm that delivers advisory, technology, and managed services to clients across both the commercial and public sectors. Our teams turn bold ideas into solutions that transform industries, strengthen communities, and drive meaningful impact worldwide.

Across our Chennai, Trivandrum, and Gurugram locations, you'll find opportunities where your passion and curiosity help shape what comes next. With cutting edge benefits, innovative learning and development programs, and a people first culture, we empower our people to lead with purpose.

We continue to expand our teams and capabilities across India, investing in state-of-the-art offices and high impact work. Here, you'll collaborate with experts from around the world, build deep expertise, explore new domains, and accelerate your professional growth while making a real impact.

What We Offer

At Guidehouse India, we are committed to supporting the well-being of our people and their families at every stage of life. We offer competitive compensation and a comprehensive benefits package designed to help you thrive both inside and outside the workplace.

Our benefits include resources such as in house physician consultations, nutritious food options at the workplace, and confidential counseling through our Employee Assistance Program, along with other wellness focused offerings that support your overall well being.

Our comprehensive learning and development programs ensure you're continuously upskilled and ready to tackle what's next, so you can shape your own career path while contributing to meaningful, purpose driven work.