Process Specialist / QA - RCM

The Opportunity

Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes.

Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long-term, healthcare organizations must empower leaders, clinicians, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients.

Joining the Huron team means you’ll help our clients evolve and adapt to the rapidly changing healthcare environment and optimize existing business operations, improve clinical outcomes, create a more consumer-centric healthcare experience, and drive physician, patient and employee engagement across the enterprise.

Join our team as the expert you are now and create your future.

Position Summary

As a QA - Credit Balance, you will be responsible for team handling, work allocation, client interactions and generate, distribute RCM metrics reports to the leadership team.
Excellent communication skills, attention to detail, and strong technical and problem solving skills are essential aspects of this role.

Qualifications

JOB DETAILS:
• Experience in handling a team / group of 15 to 20 FTEs
• Thorough understanding of RCM processes like Billing, Cash Posting, Credit Balance, Accounts Receivables, Denial Management & Correspondence review
• Very good understanding of RCM metrics like Days in AR, Ageing above 90 days, Collections and bad debt
• Periodically review teams performance and recommend performance improvement plan wherever required
• Hands on in preparing daily, weekly & monthly operational metrics reports from the Practice Management/Billing System and workflow tool using MS-Excel
• Identify trends and patterns from the generated reports and initiate action plan to resolve the AR issues
• Responsible for work allocation / distribution to the team and monitor the team work
• Create and maintain daily operational scorecards to track and report KPI’s; assist in volume forecast and capacity planning as required
• Generate and distribute management reports in accurate and timely manner
• Perform data analysis for generating reports on periodic basis including adhocs
• Establish a strong relationship with Team Managers by demonstrating the gaps, trends & patterns identified during the data/report compilation
• Suggest ways of improving the process using Lean Six Sigma methodology and suggesting automation of repetitive processes
• Able to interact with the client effectively
• Willing to work in night shift / US timings

QUALIFICATIONS:

• 5+ years of industry experience
• 3+ year Experience in relevant billing functions is a must
• Proficient in MS Excel and creating Excel macros
• Strong ability to analyze raw data, draw conclusions and develop actionable recommendations
• Ability to handle multiple tasks of reporting simultaneously
• Ability to adapt quickly to new and changing technical environments as well as strong analytical, problem solving and quantitative abilities.
Solid verbal and written communication skills are required.


Education/Certifications:
• Graduate in any disclipline.

Posting Category

Healthcare

Opportunity Type

Regular

Country

India