Specialist - Quality
Location: Indore, India
Employment Type: Full Time
Job Overview
The Specialist - Quality is responsible for ensuring quality compliance, process adherence, and performance improvement within Revenue Cycle Management (RCM) and Accounts Receivable (AR) Follow-Up operations. The role focuses on auditing transactions, identifying process gaps, conducting calibrations, managing escalations, delivering actionable feedback, and driving continuous quality improvement initiatives.
The position works closely with Operations and Training teams to maintain quality standards, improve agent performance, and ensure compliance with client and organizational requirements.
Key Responsibilities
Quality Auditing & Compliance
Conduct quality audits for Onshore and Business Service Operations (BSO) teams.
Review and evaluate AR Follow-Up and Denials Management transactions for accuracy and compliance.
Perform audits according to approved weekly and monthly audit plans.
Conduct Process Knowledge Tests (PKTs) for team members.
Ensure adherence to process guidelines, quality standards, and client requirements.
Identify errors, compliance risks, and process deviations.
Performance Monitoring & Feedback
Provide structured feedback to team members based on audit findings.
Share audit observations and improvement recommendations with Operations and Quality teams.
Monitor quality performance trends and identify recurring issues.
Develop action plans to improve individual and team performance.
Support performance improvement initiatives through coaching and mentoring.
Training & Development
Participate in process discussions and training sessions.
Support development and delivery of quality-related training programs.
Conduct weekly feedback sessions based on audit trends and quality themes.
Train team members on process updates, quality expectations, and best practices.
Collaborate with Operations and Training teams to address identified knowledge gaps.
Calibration & Quality Governance
Participate in weekly and bi-weekly calibration sessions.
Ensure consistency in quality evaluations and audit methodologies.
Assist in developing audit frameworks, scorecards, and sampling plans.
Support quality governance initiatives and compliance reviews.
Escalation Management
Manage internal and external quality-related escalations.
Investigate issues, identify root causes, and recommend corrective actions.
Work closely with Operations Supervisors and Team Leads to resolve escalations effectively.
Track escalation closure and ensure preventive measures are implemented.
Reporting & Analytics
Generate and share quality performance reports with stakeholders.
Analyze audit findings and quality metrics.
Identify trends and recommend process improvements.
Support operational decision-making through quality insights and data analysis.
Continuous Improvement
Identify opportunities to improve quality, productivity, and customer experience.
Collaborate with stakeholders to implement process improvement initiatives.
Support standardization and quality enhancement activities across teams.
Promote a culture of continuous learning and operational excellence.
Perform additional duties as assigned.
Qualifications
Graduate in any discipline from a recognized university.
Certification in Quality Management, Six Sigma, Lean, or Healthcare Operations is an added advantage.
Experience (Minimum Required)
Minimum 3+ years of experience in:
Accounts Receivable (AR) Follow-Up
Revenue Cycle Management (RCM)
Denials Management
Healthcare Operations
Strong understanding of:
AR Processes
Denial Management
Healthcare Revenue Cycle Operations
Quality Assurance Practices
Experience in:
Transaction Auditing
Quality Monitoring
Calibration Sessions
Escalation Management
Process Improvement
Strong analytical and problem-solving skills.
Excellent written and verbal communication skills.
Ability to present findings and feedback effectively.
Strong stakeholder management and coaching abilities.
Required Skills
Quality Auditing
Revenue Cycle Management (RCM)
Accounts Receivable (AR) Follow-Up
Denials Management
Quality Assurance
Root Cause Analysis
Coaching & Feedback
Escalation Management
Process Improvement
Calibration Management
Reporting & Analytics
Stakeholder Management
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