Quality Analyst

CPSI; India; On-site; INR 600,000 - 840,000; Full time

Job summary

CPSI in India seeks an experienced AR/RCM specialist to document and improve US Healthcare RCM quality scores across posting and AR follow-up processes. You will mentor teams, create cheat sheets, and report trends in production and denials, with room to assume AR Analyst duties temporarily as needed.

Strong English writing, payer knowledge, and familiarity with CPT and denial codes are essential for success in this role.

Qualifications

• 5+ years in US Healthcare RCM posting and AR follow-up.
• Understanding of Provider claim lifecycle.
• Knowledge of major payer types.
• Knowledge of denials, CPT codes, transaction codes and reason codes.
• Excellent English written and spoken communication.

Responsibilities

• Document and publish quality scores.
• Create cheat sheets and reference guides for teams.
• Move into AR Analyst role temporarily if needed.
• Identify trends in production, denials and global issues.
• Maintain production and quality standards.

Skills

English communication

US Healthcare knowledge

RCM basics

Tools

Claims posting systems

AR follow-up tools

Job description

• Document and publish quality scores. Council and mentor team members to improve their quality scores.
• Create cheat sheets and reference guides to assist teams in improving quality.
• Be able to move seamlessly into the AR Analyst role temporarily if the need arises.
• Identify and report common trends in teams' production, denials and any global issues.
• Maintain production and quality standards declared by the organization.

Requirements

• 5+ Years of experience in US Healthcare RCM in posting transactions and AR Follow-up.
• Should have a thorough understanding of Provider claim life cycle.
• Must have thorough knowledge of major insurance payers.
• Must have thorough knowledge of common denials.
• Must know standard practices of RCM.
• Must have understanding of common acronyms and nomenclature in US Healthcare.
• Should have excellent written and communication skills in English. Good grammar is a must.
• Must have fair knowledge of common CPT codes, transaction codes and reason codes.

Experience

5+ Years Individual Contributor Originally posted on Himalayas