Job Title: Quality Analyst/ Sr Quality Analyst
We are looking for an experienced QA / Senior QA professional with expertise in Revenue Cycle Management (RCM) – AR Voice Process. The candidate will be responsible for monitoring and auditing AR calling activities, ensuring process compliance, identifying quality gaps, performing Root Cause Analysis (RCA), and driving continuous quality improvement initiatives.
The ideal candidate should possess strong knowledge of medical billing, denial management, insurance follow-up, and quality auditing processes along with excellent analytical and communication skills.
Key Responsibilities
Quality Monitoring & Auditing
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Conduct quality audits for AR voice calls and documentation.
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Evaluate calls based on process adherence, accuracy, compliance, and communication skills.
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Ensure adherence to HIPAA regulations and client-specific guidelines.
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Monitor agent performance and identify improvement opportunities.
Root Cause Analysis (RCA)
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Perform RCA for recurring errors, denials, and process deviations.
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Analyze quality trends and identify process gaps.
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Recommend corrective and preventive actions (CAPA).
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Collaborate with operations teams to reduce repeat audit failures.
Coaching & Calibration
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Provide feedback and coaching to AR callers and team leads.
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Conduct calibration sessions with internal teams and clients.
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Support training initiatives and refresher sessions.
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Assist in improving overall team quality scores.
Reporting & Analytics
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Prepare daily, weekly, and monthly QA reports.
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Track and analyze KPIs such as:
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Quality Scores
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Error Rates
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Denial Trends
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Productivity Metrics
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Compliance Scores
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Share audit insights and improvement plans with management.
Required Skills
Domain Knowledge
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Strong understanding of:
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Revenue Cycle Management (RCM)
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AR Calling Process
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Medical Billing
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Denial Management
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Insurance Follow-up
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Claims Resolution
QA & RCA Skills
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Call Auditing
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Quality Analysis
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Calibration Process
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Root Cause Analysis (RCA)
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CAPA Management
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Trend Analysis
Technical Skills
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MS Excel (Pivot Tables, VLOOKUP, Reporting)
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QA Audit Tools
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RCM/Medical Billing Applications
Eligibility Criteria
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4+ years of experience in RCM AR Voice Process.
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Minimum 1–2 years of experience in QA/Senior QA role preferred.
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Excellent verbal and written communication skills.
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Strong analytical and problem-solving abilities.
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Experience in handling client escalations and stakeholder communication is an added advantage.
Preferred Qualifications
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Experience in US Healthcare / Medical Billing domain.
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Strong understanding of payer guidelines and denial management.
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Ability to work in a fast-paced environment.
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Good team handling and mentoring skills.
