Golden Opportunities
Website:
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Job details:
Job Description
Title : Quality Manager - Revenue Cycle Management (RCM) – Chennai
Shift: 6.30pm to 3.30am
Key Responsibilities
- 10–12 years of experience in RCM with at least 3+ years in a quality leadership role
- Develop and implement quality assurance frameworks across RCM processes
- Conduct regular audits of coding, billing, and AR processes
- Ensure adherence to payer guidelines, client SOPs, and regulatory standards (HIPAA, CMS, etc.)
- Monitor accuracy, productivity, and compliance metrics
- Process Improvement
- Identify quality gaps and root causes of errors
- Drive continuous improvement initiatives (Lean, Six Sigma, etc.)
- Collaborate with operations teams to reduce denials and improve first-pass yield
- Standardize best practices across teams
- Team Management
- Lead and mentor QA analysts and auditors
- Set performance goals and KPIs for the quality team
- Conduct regular training and calibration sessions
- Ensure consistency in audit scoring and feedback
- Reporting & Analytics
- Prepare and present quality dashboards and reports to leadership and clients
- Track KPIs such as accuracy rates, denial rates, turnaround time, and rework
- Provide actionable insights to improve operational performance
- Compliance & Risk Management
- Ensure compliance with healthcare regulations (HIPAA, ICD-10, CPT, HCPCS)
- Conduct internal compliance audits
- Support external audits and client reviews
- Mitigate risks related to billing errors and revenue leakage
- Client Interaction
- Act as a quality SPOC for clients
- Participate in client calls and business reviews
- Address client escalations related to quality issues
- Align quality goals with client expectations
Key Skills & Competencies
- Strong knowledge of end-to-end RCM processes
- Expertise in medical coding, billing, and denial management
- Analytical and problem-solving skills
- Leadership and stakeholder management
- Excellent communication and presentation skills Familiarity with quality tools and methodologies
Skills Required
RoleQuality Manager - Revenue Cycle Management (RCM) - Chennai
Industry TypeITES/BPO/KPO
Functional Area
Required Education Bachelor Degree
Employment TypeFull Time, Permanent
Key Skills
- QUALITY
- QUALITY MONITORING
- RCM OPERATIONS
- REVENUE CYCLE MANAGEMENT
Other Information
Job CodeGO/JC/3116/2026
Recruiter NameDevikala D
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