Quality Assurance Analyst- Healthcare RCM

Purpose of the Role

• You will work as a Quality Analyst (QA) for Optum Shared Services in Revenue Cycle Management (RCM).
• Your main job is to

  audit processes like AR Denials Management, Cash Posting, Billing Edits, Correspondence, and Reconciliation.

• Goal: Ensure accuracy, compliance, and improve processes using Lean, Six Sigma, RCA (Root Cause Analysis), and CAPA (Corrective and Preventive Actions).

What Youll Do (Major Responsibilities)

1. Audit Work

• Check transactions in RCM processes (AR follow-up, Billing, Payment Posting).
• Identify errors and gaps.

2. Communication & Feedback

• Share findings with teams and leadership.
• Suggest improvements and mentor others.

3. Process Improvement

• Use analytical skills to find root causes.
• Drive Lean projects and process calibration with Ops and Training teams.

4. Tools & Systems

• Work with EQT (audit tool), reporting systems, MS Office, and operational systems.

5. Documentation & Tracking

• Maintain audit results, CAPA actions, and improvement metrics.

Detailed Responsibilities

• Perform quality reviews and record findings.
• Communicate issues promptly.
• Participate in meetings and projects.
• Ensure SOPs and policies are followed.
• Collaborate with leaders for training and quality improvement.

Qualifications Required:

• Graduate degree.
• Strong RCM knowledge (especially AR follow-up).
• 3+ years in QA or similar role in RCM.
• Advanced MS Office skills.
• Excellent communication and analytical skills.

Preferred:

• 3 to 5 years in healthcare RCM.
• Experience with QA methodologies and adult learning principles.
• Knowledge of Acute specialty systems (MS4, EPIC, STAR, etc.).
• Lean/Six Sigma certification is a plus.

In Short

This role is about:

• Auditing RCM processes.
• Identifying gaps and improving processes.
• Collaborating with Ops, Training, and Leadership.
• Using QA tools and methodologies to ensure accuracy and efficiency.

For quick response drop your resume at gansari@astoncarter.com or 7300523092