RCM Quality Assurance Lead
- ModMed Technologies
- 8 - 10 years
- Hyderabad
- 2 months ago
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Job Description
Your Role:
The Quality Assurance lead role will work closely with Global Partners and the COE Team to monitor and address quality-related gaps. They will also ensure that deliverables from the respective teams meet the required quality standards.
Responsibilities:
- Communicate with Global Teams and provide Audit Outcomes for the work audited by the auditors within their Team and by MMI Auditors. Proactive communication across the Teams along with data points is a key responsibility. They will use Jira, Quality Dashboards and focused presentations for the same.
- Global Teams provide Audit rebuttals. Quality Supervisors review those and respond with a decision to Global Teams. They will calibrate with the Delivery Teams in order to reduce the rebuttals to the minimum possible to avoid rework.
- Work on all Jira Tickets tagged to them for the quality concerns by Modmed Teams for their book of business( assigned Partners/specialties). They will work and resolve those within TAT
- Audit the Claims where Global Partners tagged those as uncollectible and provide feedback/ approval to write off as per the Modmed guidelines.
- Pick up projects to audit the auditors and have a focused quality review to ensure that DPU frontend quality is > 98% and backend quality is > 95%
- Supervise the Quality Auditors and provide regular updates. They have to ensure that Quality Auditors are meeting the daily productivity targets. They will keep a very close eye on the issues reported by the Clients and internal Teams and will ensure that the gaps are identified and permanently fixed within defined timelines both proactively and reactively.
- Ensure that all the Quality improvement levers are being worked on and delivered in a timely manner, as per the Quality Strategy. The issues identified and reported are being fixed through a focused plan within defined timelines.
- Keep abreast of all the Process documentation and instructions to make sure that the audits are in line with the processes laid down. They will have a strong understanding on the quality expectations for all the roles under their preview.
Skills & Requirements:
- Require 8 years of experience in RCM Domain in AR and above with at least 2-3 years as Quality supervisor leading a team of 5+ auditors in provider RCM . A hands-on Leader who is a SME in Quality Processes.
- Strong knowledge of Quality Processes
- Proven Track record of creating and implementing CAPA plans
- Highly skilled in DISCOVERY of issues related with Quality
- Strong Communication - Writing as well as oral
- Expert in Advanced Excel and PPTs
Preferred Certification in Quality Processes such as Six Sigma, TQM etc.
Job Classification
Industry: IT Services & ConsultingFunctional Area / Department: Quality AssuranceRole Category: Quality Assurance - OtherRole: Quality Assurance - OtherEmployement Type: Full timeContact Details:
Company: ModMed TechnologiesLocation(s): Hyderabad+ View Contact
Keyskills: Auditor TQM Backend Claims Quality Assurance Lead Social media Healthcare Wellness Six sigma Auditing
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ModMed Technologies
ModMed is transforming healthcare by placing doctors and patients at the center of care through an intelligent, specialty-specific cloud platform. With our electronic health records (EHR) and practice management (PM) systems, and our revenue cycle management (RCM) services
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