Quality Analyst
- Auditing & Monitoring: Conduct scheduled and ad-hoc audits of processed RCM transactions (including claim submissions, payment posting, denial handling, and eligibility verification) against defined quality parameters.
- Compliance Verification: Ensure strict adherence to HIPAA guidelines, client-specific billing rules, and regulatory requirements in all audited samples.
- Root Cause Analysis (RCA): Investigate identified errors and deviations to determine the root cause, distinguishing between process gaps, training issues, or individual errors.
- Feedback & Coaching: Provide constructive, objective feedback and collaborate with Team Leaders and Process Trainers to implement effective coaching and corrective action plans for associates.
- Reporting: Compile, analyze, and present detailed quality reports, performance trends, and audit findings to leadership, highlighting areas of risk and recommending improvements.
- Standardization: Assist in the creation and maintenance of updated process documentation, quality checklists, and standard operating procedures (SOPs).
- Calibration: Participate in quality calibration sessions to ensure consistent understanding and application of quality standards across all teams.
- Target Achievement: Ensure the entire process consistently meets the required quality and accuracy benchmarks set by both Aura BPO and the client.
- Experience: 1–3 years of direct experience as a Quality Analyst, Auditor, or in a Senior/Lead RCM role where quality monitoring was a primary function.
- Education: Any graduate or diploma holder.
- RCM Expertise: Strong, comprehensive knowledge of the entire U.S. Healthcare Revenue Cycle from front-end to back-end (including AR, Charge Entry, Payment Posting, and Denial Management).
- Analytical Ability: Proven ability to analyze large datasets, identify trends, and perform effective Root Cause Analysis (RCA).
- Communication: Excellent written and verbal communication skills required for delivering constructive feedback and preparing professional reports.
- Technical Proficiency: Proficiency in spreadsheet tools (e.g., MS Excel) for data manipulation and reporting. Experience with quality management systems is a plus.
- Compliance Focus: Deep understanding of HIPAA and RCM best practices.
- Meticulous Attention to Detail
- Objective Decision-Making
- Analytical and Investigative Mindset
- Process Compliance and Integrity
- Effective Feedback and Communication Skills
- Shift Timings: Day & Night Shift
- Work Schedule: Sunday & Monday off for day shift, Saturday & Sunday off for night shift (schedule may vary slightly based on client requirements).