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Quality Expert
AQuity Solutions India
posted 24d ago
Job Role Insights
Flexible timing
Key skills for the job
Job Description
Minimum 2 years of experience in RCM domain in US Healthcare, preferably in Quality Auditor/Expert capacity in Charge Entry process
Knowledge of end to end RCM - preferred
Conduct regular audits of charge entry transactions for accuracy, completeness, and compliance with payer-specific requirements
Ensure all charge entries are correctly captured and aligned with clinical documentation, CPT, ICD-10, HCPCS codes, and payer-specific rules with strong understanding on them
Identify discrepancies in charge entries, including missed charges, incorrect codes, and non-compliant entries
Investigate and identify trends in charge entry-related denials and rejections
Collaborate with the billing and coding teams to resolve charge entry errors and prevent recurrence
Review and validate billing codes to ensure accurate reimbursement and avoid denials
Monitor the accuracy of data entry processes for both primary and secondary claims
Monitor and analyze RCM process errors (upstream issues and downstream impact)
Provide feedback to charge entry agents based on audit results and performance metrics
Offer guidance and coaching to team members to ensure understanding and adherence to charge entry best practices
Develop training materials and deliver refresher training on charge entry processes and guidelines as needed
Participate in calibration and performance review calls in terms of quality with clients as well as the internal team
Prepare and maintain detailed reports on charge entry audits, error rates, and key performance metrics
Present regular performance reports to management, highlighting trends, issues, and areas for improvement
Should be able to analyze the trends, perform RCA, and propose solutions around the identified root causes
Ensure proper documentation of audit findings and actions taken to resolve identified issues
Should have hands-on experience in MS Excel and Google Suite experience is preferred
Knowledge of 7 Quality Tools is preferred
Knowledge of multiple EPM applications like EPIC, eCW, NextGen, GreenWay, Raintree applications is an added advantage
Should have strong analytical skills on Charge Entry along with Billing
Employment Type: Full Time, Permanent
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What people at AQuity Solutions India are saying
What AQuity Solutions India employees are saying about work life
based on 306 employees
Flexible timing
Monday to Friday
No travel
Night Shift
AQuity Solutions India Benefits
Submitted by Company
Employee Engagement Referral Bonus Free Transport 
Cafeteria Work From Home
Submitted by Employees
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AQuity Solutions India Mumbai Office Location
Mumbai, Maharashtra Office
Headquarter
Reliable Plaza, 1st Floor, Unit No. 103, Plot No K 10, Kalwa Industrial Area, Village – Elthen, Taluka & Dist Thane, Airoli, Navi Mumbai
Mumbai, Maharashtra
400708
400708
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