Assistant Manager- Qaulity (Chennai)

Job Title: Assistant Manager Quality (RCM) Job Summary The Quality Assistant Manager is responsible for overseeing and enhancing quality assurance processes across all RCM functions, billing, AR follow-up, and denial management. This role ensures compliance with client requirements, regulatory standards, and internal benchmarks while driving continuous improvement and operational excellence Key Responsibilities 1. Quality Assurance s Auditing - 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 2. 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 3. 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 4. Reporting s 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 5. Compliance s 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 6. 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 - Required Qualifications - Any graduate 812 years of experience in RCM with at least 3+ years in a quality leadership role - Key Skills s Competencies - Solid 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 .