Quality Analyst AR - Hospital Billing

cpsi; Chennai; On-site; INR 500,000 - 750,000; Full time

Job summary

cpsi is seeking a Quality Analyst to review production for errors, document quality scores, and mentor teams to uplift performance. The role emphasizes deep knowledge of US Healthcare RCM processes, CPT/transaction code usage, and effective English communication to document findings and share best practices.

Candidates should have 5+ years of experience in US Healthcare RCM, a strong grasp of claim cycles and denials, and be prepared to support AR workflows when needed.

Qualifications

• Minimum 5+ years experience in US Healthcare RCM focusing on posting transactions and AR follow-up.
• Thorough understanding of the Provider claim life cycle.
• Strong knowledge of major insurance payers and common denials.
• Proficient in CPT codes, transaction codes and reason codes.
• Excellent written and spoken English communication skills.

Responsibilities

• Review teams' production for errors and inaccuracies.
• Document and publish quality scores.
• Counsel and mentor team members to improve quality scores.
• Create cheat sheets and reference guides for quality improvement.
• Be prepared to move into AR Analyst role temporarily if needed.
• Identify and report trends in denials and global issues.
• Maintain production and quality standards declared by the organization.

Skills

US Healthcare RCM

AR follow-up

Quality assurance

English communication

CPT/transaction/reason codes knowledge

Job description

Quality Analyst

• Review teams' production for errors and inaccuracies.
• 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

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