Responsibilities of the Candidate:

Take charge of leading and managing the quality team by providing essential guidance, training, and performance assessments.
Make sure that the team follows all company policies and procedures.
Encourage team members to reach their individual and team performance objectives.
Oversee daily audits to ensure compliance with federal, state, and payer-specific requirements, including CMS regulations, ICD-10 coding standards, and DRG-based reimbursement methodologies.
Prepare detailed reports on findings from audits and data reviews, including identifying patterns of errors and areas of concern.
Assist in the implementation of corrective actions and quality improvement initiatives to optimize revenue cycle performance and improve the accuracy of the projects.
Build and maintain positive relationships with clients, insurance companies, and other stakeholders.
Strive for high levels of client satisfaction through effective communication and problem-solving.
Ensure compliance with healthcare regulations, company policies, and industry standards.
Prepare and deliver regular performance reports to senior management.

Requirements:

A degree in any discipline is required.
Ability to work in night shift i.e. 06:00 PM to 03:00 AM IST for Gurugram.
A year of hands-on people manager experience in accounts receivable quality in the US healthcare field.
Comprehensive knowledge of accounts receivable procedures and billing practices in healthcare.
Well-versed in the insurance claim submission and reimbursement processes for Medicare, Medicaid, and commercial insurance.
Familiar with electronic medical records (EMR) and billing systems like Epic, Cerner, and Meditech.
Travel required: None