Found Description
RESPONSIBILITIES
- Lead and drive overall quality strategy across end-to-end RCM functions
- Define and implement quality frameworks, SOPs, and audit mechanisms aligned with client and regulatory standards
- Ensure compliance with CMS, HIPAA, provider guidelines, and industry regulations
- Establish strong governance models, KPIs, and quality scorecards for performance tracking
- Drive continuous quality improvement initiatives using RCA, Six Sigma, and Lean methodologies
- Identify trends in denials, errors, and audit failures and implement corrective actions
- Manage internal & external audits, ensuring audit readiness and compliance adherence
- Partner with operations teams to reduce rework, improve accuracy, and enhance first-pass yield
- Lead client quality reviews (QBRs) and act as the point of contact for quality-related escalations
- Ensure client SLA adherence, serv...