RCM Quality Assurance Specialist
Remote · India
Job Summary
Own the quality of work produced by billing associates and AI agents; audit claim work for accuracy; build and maintain QA scorecards, trackers, and dashboards; design automated or rule-based quality checks; identify root causes behind error trends and translate them into coaching for billing associates and Team Leads; surface AI error patterns to Product and Engineering with reproducible, claim-level detail; calibrate QA standards across reviewers and track key quality KPIs; ensure a high standard of accuracy in both human and AI outputs; collaborate with analytics and product teams to improve denial-management workflows.
Required Qualifications
- 4+ years in RCM, AR follow-up, or denial management with a demonstrated record of high accuracy and strong production
- Advanced Excel or Google Sheets skills (pivot tables, lookups, conditional logic) and genuine comfort working with data
- A pattern-finder who looks for root cause, not just pass or fail
- Detail-oriented and organized, able to document quality standards clearly
- Comfortable evaluating AI-generated work and giving structured, actionable feedback
- Able to work US hours (9am to 6pm ET)
Desired Qualifications
- SQL or experience querying claim data directly
- Experience with BI or analytics tools (Looker, Tableau, Metabase)
- Experience building QA automation
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