Deskripsi Pekerjaan
Are you a seasoned quality assurance professional with a deep passion for healthcare revenue cycle management? Access Healthcare Services Manila, Inc. is looking for a strategic and detail-oriented RCM Quality Manager to drive operational excellence in our Pasay City office. In this high-impact role, you will be the guardian of quality standards, ensuring that our medical billing, coding, and accounts receivable processes remain efficient, accurate, and compliant with global healthcare regulations.
You will lead a team of quality analysts, implement robust audit frameworks, and drive continuous improvement initiatives that directly impact our clients' financial outcomes. If you are a visionary leader who thrives in a fast-paced BPO environment and is committed to delivering world-class healthcare administrative solutions, we want to hear from you. Join us to accelerate your career, enjoy flexible work arrangements, and make a tangible difference in the healthcare outsourcing industry.
Tanggung Jawab
- Develop, implement, and maintain comprehensive quality assurance frameworks across all RCM workflows (Coding, Billing, Denials Management).
- Lead and mentor a team of quality analysts to achieve operational KPIs and performance targets.
- Conduct regular audits of patient accounts to ensure compliance with HIPAA, ICD-10, CPT, and payer-specific guidelines.
- Analyze quality data to identify operational bottlenecks and spearhead process improvement initiatives.
- Collaborate with cross-functional departments to address performance gaps and deliver actionable coaching feedback.
- Prepare executive-level reporting on quality metrics, trends, and risk management assessments.
- Stay current with evolving healthcare policies and insurance billing regulations to ensure organizational compliance.
Kualifikasi
- Bachelor’s degree in Healthcare Management, Nursing, Business Administration, or a related field.
- Minimum of 5 years of experience in Healthcare RCM with at least 2 years in a leadership or Quality Management capacity.
- Expert-level knowledge of medical billing, coding (ICD-10/CPT), and the full revenue cycle lifecycle.
- Strong background in BPO healthcare operations and quality auditing methodologies (e.g., Six Sigma, Lean).
- Exceptional analytical, problem-solving, and communication skills.
- Proficiency in RCM software and MS Office Suite (advanced Excel skills preferred).
- Proven ability to drive performance improvements and mentor diverse teams.