Quality Analyst-AR- Voice Process- Revenue Cycle Management

Quality Analyst- Revenue Cycle Management

What You Will Do

• Conduct quality audits on inpatient and observation accounts requiring Notification on Admission (NOA), in line with sampling guidelines.
• Validate accurate submission of notifications through portals, EDI, fax, or calls, and ensure timely initiation of non-clinical authorizations.
• Review documentation accuracy, including reference numbers, authorization numbers, payer timelines, and compliance requirements.
• Perform root cause analysis on identified defects, develop CAPA plans, and track recurring trends such as missed NOAs, delays, and documentation gaps.
• Provide actionable feedback on audit findings, support process clarifications, lead performance improvement discussions, and participate in periodic team reviews.
• Prepare daily, weekly, and monthly quality reports, track SLA and accuracy metrics, and contribute to governance reviews.
• Participate in calibration sessions, refresher initiatives, and training programs to strengthen process quality.

What You Will Need

• Strong knowledge of US Healthcare Revenue Cycle Management (RCM).
• Strong understanding of Authorization and Notification on Admission (NOA) workflows, backed by relevant hands-on experience.
• At least 3 years of experience in US Healthcare RCM.
• Strong analytical, problem-solving, and attention-to-detail skills.
• Good communication skills with the ability to provide clear, constructive feedback.
• Willingness to work on Night Shifts.
• Any UG Degree - Mandatory (Diploma not Eligible)
• Document proofs for Recent Employment.

What Would Be Nice To Have

• Prior experience in Quality Audits / Quality Assurance within US Healthcare RCM
• Exposure to multiple RCM functions (AR, Denials, Charge Entry, Payment Posting)
• Experience in trend analysis, data interpretation, and quality reporting
• Familiarity with audit tools, scorecards, and quality metrics
• Knowledge of HIPAA compliance and quality standards
• Ability to mentor team members and support performance improvement initiatives

Work location/ Office Address:

Guidehouse India Pvt Ltd, RMZ Spire, Silpagram Craft Village, HITEC City, Hyderabad, Telangana- 500081

Note:

Employees must opt for cab mandatorily, we expect candidates to be within 25 kms radius from the office location. Cab facility will be extended subject to feasibility.