Quality Analyst - Accounts Receivable (US Healthcare) - Noida

Job Summary:

The Quality Analyst in the Accounts Receivable (AR) department for US Healthcare is responsible for ensuring that the processes and workflows related to AR management are executed with precision, compliance, and efficiency. The role involves monitoring, analyzing, and improving the quality of AR operations, ensuring compliance with healthcare regulations, and enhancing the overall financial performance of the AR department.

Key Responsibilities:

1. Quality Assurance and Monitoring:

- Conduct regular audits of AR processes to ensure accuracy and compliance with established standards and healthcare regulations.

- Monitor AR workflows to identify deviations, discrepancies, and areas for improvement.

- Develop and implement quality control procedures to enhance the efficiency and accuracy of AR activities.

2. Data Analysis and Reporting:

- Analyze AR data to identify trends, patterns, and root causes of issues.

- Generate detailed reports on AR performance, including key metrics such as days sales outstanding (DSO), claim denials, and payment posting accuracy.

- Provide actionable insights and recommendations based on data analysis to improve AR processes.

3. Compliance and Regulation:

- Ensure that AR processes adhere to relevant healthcare regulations, including HIPAA, Medicare, Medicaid, and other payer-specific guidelines.

- Stay updated with changes in healthcare laws and regulations and adjust AR processes accordingly.

4. Process Improvement:

- Collaborate with AR team members to identify process inefficiencies and implement corrective actions.

- Develop and deliver training programs to enhance the skills and knowledge of AR staff.

- Lead continuous improvement initiatives to streamline AR workflows and enhance overall efficiency.

5. Customer and Stakeholder Communication:

- Liaise with internal and external stakeholders, including insurance companies, patients, and healthcare providers, to resolve AR issues.

- Address and resolve customer complaints and queries related to AR processes.

- Ensure effective communication and coordination between AR team members and other departments.

6. Documentation and Record Keeping:

- Maintain accurate and up-to-date documentation of AR processes, audit results, and quality assurance activities.

- Ensure all AR records are securely stored and compliant with data protection regulations.

#### Qualifications:

- **Education:** Bachelor's degree in Finance, Accounting, Healthcare Administration, or a related field.

- **Experience:** Minimum of 3-5 years of experience in AR, preferably within the US healthcare industry. Previous experience in a quality assurance or auditing role is highly desirable.

- Skills:

- Strong analytical and problem-solving skills.

- Excellent attention to detail and organizational skills.

- Proficiency in AR software and healthcare billing systems (e.g., EPIC, Cerner).

- Knowledge of healthcare regulations and compliance standards.

- Strong communication and interpersonal skills.

- Ability to work independently and collaboratively in a team environment.