Hiring For Quality Lead (US RCM)

Dear Candidates,

We are Hiring for Quality Team Lead for our US RCM process, Below are the job summary and details for your reference.

Job Summary: The Quality Analyst Team Lead for AR Calling is responsible for leading a team of quality analysts who evaluate the performance of accounts receivable staff involved in billing and collections processes. This role involves overseeing quality assurance activities, providing guidance and training to analysts, analyzing data, and implementing improvement initiatives to optimize revenue cycle management.

Responsibilities:

1. Team Leadership: Lead a team of quality analysts responsible for monitoring calls, evaluating performance metrics, and ensuring adherence to quality standards within the accounts receivable department.
2. Quality Assurance Oversight: Oversee the quality assurance process, including call monitoring, audit reviews, and performance evaluations, to assess the effectiveness, accuracy, and compliance of AR calling activities.
3. Performance Metrics Analysis: Analyze key performance indicators (KPIs) such as call resolution time, accounts resolved, denial rates, aging of accounts receivable, and revenue collections to identify trends, areas for improvement, and training needs.
4. Feedback and Coaching: Provide constructive feedback to accounts receivable staff based on quality evaluation results, call monitoring findings, and performance metrics analysis. Offer coaching, training, and support to improve performance and achieve departmental goals.
5. Training and Development: Develop and deliver training programs, refresher courses, and ongoing education sessions for accounts receivable staff to enhance skills, compliance with regulations, and effectiveness in resolving billing issues.
6. Quality Assurance Tools and Systems: Ensure the effective utilization of quality assurance tools, call monitoring systems, and performance tracking software to streamline processes, capture data accurately, and generate meaningful insights for decision-making.
7. Process Improvement: Identify opportunities to streamline workflows, enhance operational efficiency, reduce denials, accelerate payment cycles, and optimize revenue generation through process improvements and best practices.
8. Cross-Functional Collaboration: Collaborate with other departments such as Billing, Coding, Revenue Cycle Management, Compliance, and Customer Service to address systemic issues, share best practices, and ensure alignment of processes and objectives.
9. Documentation and Reporting: Maintain accurate records of quality evaluations, audit findings, coaching sessions, and performance improvement plans. Prepare reports and presentations to communicate findings, trends, and recommendations to senior management and stakeholders.
10. Compliance Assurance: Ensure compliance with healthcare regulations (e.g., HIPAA, Fair Debt Collection Practices Act), payer guidelines, and internal policies related to AR calling, billing, collections, and patient communication.

Qualifications:

• Bachelor's degree in Healthcare Administration, Business Administration, Finance, or related field preferred.
• Minimum of 5 - 8 years of experience in healthcare revenue cycle management, accounts receivable, billing, or related area.
• Previous experience in a leadership or supervisory role preferred, with demonstrated ability to mentor and develop team members.
• Proficiency in using quality assurance tools, call monitoring systems, and performance tracking software.
• Strong understanding of medical billing terminology, coding systems (e.g., ICD-10, CPT), and reimbursement methodologies (e.g., Medicare, Medicaid, commercial payers).
• Knowledge of regulatory requirements and compliance standards governing healthcare billing and collections practices.
• Excellent analytical skills, attention to detail, and ability to interpret data and metrics.
• Effective communication skills, both verbal and written, with the ability to provide clear feedback and coaching to staff.
• Customer service orientation and ability to interact professionally with patients, insurance companies, and internal stakeholders.
• Certification in Healthcare Financial Management (CHFP), Certified Revenue Cycle Representative (CRCR), or similar credentials desirable.

Contact HR - 7397746784 / 7397746136

Regards

HR Team

Qway Technologies