Walk-in || Quality Analyst

Role & responsibilities

• Perform quality audits across RCM functions including Eligibility Verification, Prior Authorization, Charge Entry, Medical Coding, Payment Posting, AR Follow-up, and Denial Management.
• Evaluate transactions and processes for accuracy, compliance, and adherence to client-specific guidelines.
• Provide detailed audit feedback, coaching insights, and corrective action recommendations to operational teams.
• Analyze quality trends, identify root causes of errors, and implement preventive measures.
• Prepare and present quality reports, scorecards, and performance dashboards.
• Conduct calibration sessions with Operations and Training teams to ensure audit consistency.
• Ensure compliance with HIPAA, payer regulations, and organizational policies.
• Support process improvement initiatives and quality enhancement programs.

Preferred candidate profile

• Graduate in any discipline.
• 5+ years of experience in Quality Assurance within US Healthcare RCM.
• Strong expertise in AR Follow-up, Denial Management, Medical Billing, Payment Posting, and related RCM processes.
• Experience in quality auditing, root cause analysis, and process improvement.
• Excellent analytical, reporting, and communication skills.
• Advanced proficiency in MS Excel and quality reporting tools.
• Thorough understanding of HIPAA, payer guidelines, and healthcare compliance standards.