RCM QA Specialist

ModMed India; Hyderabad; On-site; INR 600,000 - 900,000; Full time

Benefits offered by this job

Meals & Snacks

Insurance Coverage

Annual wellness allowance

Leave benefits

Parental leave

Company holidays

Job summary

ModMed India is seeking a RCM QA Specialist in Hyderabad to conduct audits of transactions and call reviews, ensuring compliance with policies and payer requirements. The role includes providing feedback in 1:1 sessions and team huddles to uphold quality standards.

The candidate will document errors, participate in FMEA, and collaborate with operations on calibration. Regular audit reports will track quality trends for internal teams.

Qualifications

• Bachelor’s degree in any discipline.
• 5+ years total RCM experience, with at least 1 year in an auditing role.
• Minimum 4 years of experience in Revenue Cycle Management (RCM).
• Proficiency in basic Excel for data tracking and reporting.
• Strong accountability, communication, customer focus, and agility.

Responsibilities

• Conduct detailed audits of transactions and call reviews to ensure strict adherence to company policies, regulatory guidelines, and payer requirements.
• Provide direct, constructive verbal feedback during 1:1 sessions or team huddles to help colleagues improve and align with quality standards.
• Diligently identify and document errors or non‑compliant practices using standard protocols.
• Participate in Failure Mode and Effects Analysis (FMEA) sessions to identify root causes and propose data-driven improvement suggestions.
• Collaborate with operations teams during calibration sessions to clarify audit guidelines and share knowledge.
• Create daily, weekly, and monthly audit reports to provide visibility into quality trends for internal teams.
• Respond to audit rebuttals in a timely manner, escalating complex issues to senior leadership when necessary.

Skills

RCM experience

Auditing

Excel

Accountability

Communication

Customer focus

Agility

Education

Bachelor’s degree

Tools

Excel

Job description

RCM QA Specialist

Location: Hyderabad

Department: Revenue Cycle Management (RCM)

Reports to: Team Manager, Quality Assurance

Responsibilities

• Conduct detailed audits of transactions and call reviews to ensure strict adherence to company policies, regulatory guidelines, and payer requirements.
• Provide direct, constructive verbal feedback during 1:1 sessions or team huddles to help colleagues improve and align with quality standards.
• Diligently identify and document errors or non‑compliant practices using standard protocols.
• Participate in Failure Mode and Effects Analysis (FMEA) sessions to identify root causes and propose data-driven improvement suggestions.
• Collaborate with operations teams during calibration sessions to clarify audit guidelines and share knowledge.
• Create daily, weekly, and monthly audit reports to provide visibility into quality trends for internal teams.
• Respond to audit rebuttals in a timely manner, escalating complex issues to senior leadership when necessary.

Qualifications

• Bachelor’s degree in any discipline.
• 5+ years of total RCM experience is preferred, with at least 1 year specifically in an auditing role.
• Minimum 4 years of experience in Revenue Cycle Management (RCM).
• Proficiency in basic Excel for data tracking and reporting.
• Strong accountability, communication, customer focus, and agility.

Benefits

• Meals & Snacks: Complimentary office lunches & dinner on select days and healthy snacks delivered to your desk.
• Insurance Coverage: Comprehensive health, accidental, and life insurance plans, including coverage for family members, all at no cost to employees.
• Annual wellness allowance to support your well‑being and productivity.
• Earned, casual, and sick leave to maintain a healthy work‑life balance.
• Bereavement leave, extended medical leave options.
• Paid parental leave, including maternity, paternity, adoption, surrogacy, and abortion leave.
• Celebration leave for special events, and company‑paid holidays.

Equal Opportunity Employer

ModMed is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.