Quality Assurance Manager
About the role
The Quality Assurance Manager will lead and strengthen the Quality Assurance function across US Healthcare Revenue Cycle Management (RCM) operations. The role involves overseeing QA across multiple RCM processes, developing and improving QA frameworks, conducting root cause analyses, leveraging automation and AI, monitoring quality dashboards, ensuring compliance with HIPAA and CMS guidelines, and leading the QA team. The manager will also collaborate with various departments to improve quality outcomes and present quality metrics to clients.
Must have
- Bachelor's degree in Healthcare Management, Business Administration or a related discipline.
- 7+ years of US Healthcare RCM experience, including 4+ years in Quality Assurance and 3+ years in people leadership.
- Strong knowledge of Medical Billing, AR Management, Denial Management, Payment Posting and Medical Coding.
- In-depth understanding of HIPAA, CMS guidelines and payer compliance requirements.
- Experience in continuous improvement, process optimization and root cause analysis; Lean or Six Sigma exposure preferred.
- Exposure to automation, Al-enabled solutions or digital transformation is highly desirable.
- Proficiency in Advanced Excel, Power BI or Tableau.
- CPC, CCS, CRCP, Lean Six Sigma or related certifications are an advantage.
- Strong leadership, communication, analytical and stakeholder management skills.
Technologies
- Excel
- Power BI
- Six Sigma
- Tableau
Highlights
The position requires significant experience in US Healthcare RCM and people leadership. Exposure to Lean or Six Sigma, automation, and AI-enabled solutions is highly desirable. Relevant certifications such as CPC, CCS, CRCP, or Lean Six Sigma are considered an advantage.
Jobs across Sri Lanka, watched for you.Colombo, Sri Lanka