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Data Marshall
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Payor Lead/ Team Lead Payor

Payor Lead/ Team Lead Payor

Data Marshall

5 - 9 years

5 - 8 Lacs

hyderabad

Posted:1 month ago| Platform:

Apply

Skills Required

quality audit compliance payer side healthcare rcm revenue cycle management healthcare bpo us healthcare denial management medical billing optimization auditing

Work Mode

Work from Office

Job Type

Full Time

Job Description

Job Summary:

Quality Lead

Key Responsibilities:

Quality Assurance & Process Improvement:

Monitor and ensure compliance with RCM quality standards and accuracy metrics.
Identify process gaps and implement corrective and preventive measures.
Develop and refine quality control methodologies, including DPU and DPO analysis.

Audits & Root Cause Analysis:

Perform Root Cause Analysis (RCA) on errors and denials to minimize rework.

Team Management & Training:

Lead and mentor a team of quality analysts.
Provide feedback and conduct training sessions to improve overall performance.
Ensure adherence to SLA.

Reporting & Analytics:

Prepare and present quality reports, trends, and action plans to senior management.
Track and analyze key quality metrics for continuous improvement.
Utilize data-driven insights to enhance accuracy and productivity.

Required Skills & Experience:

Minimum
5 years of experience
in Payor Services, with
at least 6 months as a Team Lead on paper
.
Strong knowledge of Payor guidelines and RCM workflows.
Experience in quality methodologies like
DPU, DPO, RCA
.
Hands-on experience with
quality audits, compliance, and process optimization
.
Proficiency in RCM tools and software, including Excel and reporting dashboards.
Strong analytical, problem-solving, and communication skills.
Ability to work in a fast-paced, deadline-driven environment.
Strong knowledge of claims adjudication and experience working on the Payor side.

Interested Candidates Kindly reach out:

HR Keerthi

Contact:8639447794

Email:keerthi.kasoji@datamarshall.com

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