RCM Quality Assurance Analyst

About the role

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.

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.

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.