RCM Quality and Outcome Improvement Analyst - Remote

Overview

The RCM Quality and Outcome Improvement Analyst is a key position within the Modmed India Operations, responsible for analyzing claims and improving process efficiency to enhance customer outcomes.

In Short

• Play a critical role in meeting productivity targets and delivering high customer service.
• Identify opportunities to improve workflows and reduce non-meaningful touches.
• Manage online portals and follow up with payers.
• Analyze claims for credentialing issues and quality improvements.
• Run reports and maintain status trackers for claims.
• Review Practice Instructions and enhance workflows.
• Analyze KPIs and ensure practices meet health scorecard standards.
• Review Jira tickets for timely resolution and recommend fixes.
• Contribute to plans of action for practice escalations.
• Assist in monitoring Service Legal Agreements (SLA).

Requirements

• 5+ years of experience in Provider RCM, with 2 years in a leadership role.
• Strong understanding of RCM processes and best practices.
• Experience in process improvements and six sigma quality projects.
• Expertise in US Healthcare RCM functions.
• Comprehensive knowledge of claim submission and coding guidelines.
• Knowledge of various insurance carriers.
• Advanced Excel skills for data analysis and visualization.
• Exceptional communication skills.
• Commitment to developing expertise in ModMed products.
• Able to work US night shifts in a hybrid model.

Benefits

• Comprehensive medical, dental, and vision benefits.
• 401(k) matching contributions.
• Generous Paid Time Off and Paid Parental Leave.
• Company paid Life and Disability benefits.
• Professional development opportunities.
• Global presence and in-person collaboration opportunities.
• Weekly catered meals and wellness rooms.