Remote RCM Quality Assurance Lead

Summary

Join ModMed, a team of passionate problem-solvers on a mission to modernize healthcare through an intelligent cloud platform. We're hiring a RCM Quality Assurance Lead to join our quality team focused on best practices.

Requirements

• Require 8 years of experience in RCM Domain in AR and above with at least 2-3 years as Quality supervisor leading a team of 5+ auditors in provider RCM
• A hands-on Leader who is a SME in Quality Processes
• Strong knowledge of Quality Processes
• Proven Track record of creating and implementing CAPA plans
• Highly skilled in DISCOVERY of issues related with Quality
• Strong Communication - Writing as well as oral
• Expert in Advanced Excel and PPTs

Responsibilities

• Communicate with Global Teams and provide Audit Outcomes for the work audited by the auditors within their Team and by MMI Auditors
• Proactive communication across the Teams along with data points is a key responsibility
• They will use Jira, Quality Dashboards and focused presentations for the same
• Global Teams provide Audit rebuttals. Quality Supervisors review those and respond with a decision to Global Teams
• They will calibrate with the Delivery Teams in order to reduce the rebuttals to the minimum possible to avoid rework
• Work on all Jira Tickets tagged to them for the quality concerns by Modmed Teams for their book of business( assigned Partners/specialties)
• They will work and resolve those within TAT
• Audit the Claims where Global Partners tagged those as uncollectible and provide feedback/ approval to write off as per the Modmed guidelines
• Pick up projects to audit the auditors and have a focused quality review to ensure that DPU frontend quality is > 98% and backend quality is > 95%
• Supervise the Quality Auditors and provide regular updates
• They have to ensure that Quality Auditors are meeting the daily productivity targets
• They will keep a very close eye on the issues reported by the Clients and internal Teams and will ensure that the gaps are identified and permanently fixed within defined timelines both proactively and reactively
• Ensure that all the Quality improvement levers are being worked on and delivered in a timely manner, as per the Quality Strategy
• The issues identified and reported are being fixed through a focused plan within defined timelines
• Keep abreast of all the Process documentation and instructions to make sure that the audits are in line with the processes laid down
• They will have a strong understanding on the quality expectations for all the roles under their preview

Preferred Qualifications

Preferred Certification in Quality Processes such as Six Sigma, TQM etc

Benefits

• Comprehensive benefits package including medical for you, your family, and your dependent parents
• The company supported community engagement opportunities along with a paid Voluntary Time Off day to use for volunteering in your community of interest
• Global presence, and in-person collaboration opportunities; dog-friendly HQ (US), Hybrid office based roles and remote availability
• Company-sponsored Employee Resource Groups that provide engaged and supportive communities within ModMed
• Comprehensive medical, dental, and vision benefits, including a company Health Savings Account contribution
• 401(k): ModMed provides a matching contribution each payday of 50% of your contribution deferred on up to 6% of your compensation
• After one year of employment with ModMed, 100% of any matching contribution you receive is yours to keep
• Generous Paid Time Off and Paid Parental Leave programs
• Company paid Life and Disability benefits, Flexible Spending Account, and Employee Assistance Programs
• Company-sponsored Business Resource & Special Interest Groups that provide engaged and supportive communities within ModMed
• Professional development opportunities, including tuition reimbursement programs and unlimited access to LinkedIn Learning
• Global presence and in-person collaboration opportunities; dog-friendly HQ (US), Hybrid office-based roles and remote availability for some roles
• Weekly catered breakfast and lunch, treadmill workstations, Zen, and wellness rooms within our BRIC headquarters