Quality Assurance Manager
Access Healthcare is looking for an experienced Quality Assurance (QA) Manager to lead and oversee the Quality Assurance team specifically managing Patient Accounts Receivable (AR) and Claims processes. The ideal candidate will have 5 to 7 years of experience managing healthcare processes and QA specialists, ensuring compliance with healthcare regulations, process efficiency, and quality standards.
Key Responsibilities:
- Lead and manage the QA team, providing mentorship, guidance, and performance management.
- Develop and implement QA frameworks and strategies to enhance accuracy, efficiency, and compliance in Patient AR & Claims management.
- Monitor key performance indicators (KPIs) and initiate corrective actions to drive continuous improvement.
- Ensure adherence to US healthcare regulations (HIPAA, CMS guidelines, payer policies, etc.).
- Conduct regular audits, risk assessments, and root cause analyses to address quality gaps.
- Collaborate with Operations, Training, and Compliance teams to enhance process efficiency and training programs.
- Oversee quality reviews, including calibration sessions and coaching for QA Specialists.
- Prepare and present QA reports and dashboards to senior management, providing insights and recommendations.
- Drive initiatives to enhance customer experience, compliance, and process excellence.
Qualifications & Experience:
- 5 to 7 years of experience in Healthcare BPO Quality Assurance, specifically in Patient AR and Claims management.
- Proven experience leading QA teams in a high-volume healthcare BPO setting.
- Strong understanding of US healthcare revenue cycle management (RCM), claims adjudication, payer policies, and denial management.
- Expertise in process auditing, compliance, and quality control frameworks.
- Familiarity with QA methodologies, Six Sigma, Lean, or process improvement tools is a plus.
- Proficiency in data analysis, reporting tools, and QA dashboards.
- Strong communication, leadership, and stakeholder management skills.
- Certification in Quality Management, Six Sigma, or Healthcare Compliance is an advantage.
Access Healthcare is looking for an experienced Quality Assurance (QA) Manager to lead and oversee the Quality Assurance team specifically managing Patient Accounts Receivable (AR) and Claims processes. The ideal candidate will have 5 to 7 years of experience managing healthcare processes and QA specialists, ensuring compliance with healthcare regulations, process efficiency, and quality standards.
Key Responsibilities:
- Lead and manage the QA team, providing mentorship, guidance, and performance management.
- Develop and implement QA frameworks and strategies to enhance accuracy, efficiency, and compliance in Patient AR & Claims management.
- Monitor key performance indicators (KPIs) and initiate corrective actions to drive continuous improvement.
- Ensure adherence to US healthcare regulations (HIPAA, CMS guidelines, payer policies, etc.).
- Conduct regular audits, risk assessments, and root cause analyses to address quality gaps.
- Collaborate with Operations, Training, and Compliance teams to enhance process efficiency and training programs.
- Oversee quality reviews, including calibration sessions and coaching for QA Specialists.
- Prepare and present QA reports and dashboards to senior management, providing insights and recommendations.
- Drive initiatives to enhance customer experience, compliance, and process excellence.
Qualifications & Experience:
- 5 to 7 years of experience in Healthcare BPO Quality Assurance, specifically in Patient AR and Claims management.
- Proven experience leading QA teams in a high-volume healthcare BPO setting.
- Strong understanding of US healthcare revenue cycle management (RCM), claims adjudication, payer policies, and denial management.
- Expertise in process auditing, compliance, and quality control frameworks.
- Familiarity with QA methodologies, Six Sigma, Lean, or process improvement tools is a plus.
- Proficiency in data analysis, reporting tools, and QA dashboards.
- Strong communication, leadership, and stakeholder management skills.
- Certification in Quality Management, Six Sigma, or Healthcare Compliance is an advantage.