RCM Quality Assurance Analyst

Position Overview:

The RCM QA Analyst will be responsible for conducting audits across revenue cycle processes to ensure accuracy, consistency, and compliance. This role supports the success of a newly formed offshore team and established onshore teams by providing structured quality feedback and identifying opportunities for process and performance improvements. The analyst is expected to be cross-functional across RCM operations (insurance verification, billing, collections, cash applications, etc.), and will contribute directly to ensuring high-quality output from both onshore and offshore partners. Feedback from audits will be routed to department managers for formal coaching and development.

Key Responsibilities

• Perform audits on revenue cycle tasks and accounts to ensure accuracy and adherence to policies.
• Participate in weekly, monthly, and quarterly audit cycles.
• Document audit findings and maintain accuracy scores in shared tracking tools (initially Excel-based).
• Collaborate with department managers to route and deliver feedback to team members.
• Contribute to QA scorecards and help define audit metrics over time.
• Remain up to date on RCM processes and maintain a working knowledge of all related systems.
• Participate in calibration and audit consistency discussions.
• Support ongoing training efforts by identifying knowledge gaps or recurring issues.
• Help beta test or onboard future QA tools (e.g., Kaleidoscope, Advantx).
• Other duties as assigned.

Required Skills:

Qualifications

• Minimum 3-5 years of hands-on Revenue Cycle Management experience.
• Familiarity with billing, A/R follow-up, and denial resolution required.
• High attention to detail and accuracy in audit documentation.
• Effective communicator capable of collaborating with offshore teams and internal stakeholders.
• Strong Excel and reporting skills required; Advantx and SIS experience preferred.
• Flexible and adaptive to changing systems, tools, and team structures.