RCM Quality Assurance Lead

Posted 6 Days Ago
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Hyderabad, Telangana
7+ Years Experience
Healthtech • Software • Telehealth
The Role
The RCM Quality Assurance Lead will oversee quality practices by monitoring compliance with quality standards, managing communications regarding audit outcomes, reviewing audit rebuttals, and supervising quality auditors to ensure productivity and quality improvements within set timelines.
Summary Generated by Built In

We are united in our mission to make a positive impact on healthcare. Join Us! 

  • South Florida Business Journal, Best Places to Work 2024
  • Inc. 5000 Fastest-Growing Private Companies in America 2024
  • 2024 Black Book Awards, ranked #1 EHR in 11 Specialties
  • 2024 Spring Digital Health Awards, “Web-based Digital Health” category for EMA Health Records (Gold)
  • 2024 Stevie American Business Award (Silver), New Product and Service: Health Technology Solution (Klara)

Who we are:

We Are Modernizing Medicine (WAMM)! We’re a team of bright, passionate, and positive problem-solvers on a mission to place doctors and patients at the center of care through an intelligent, specialty-specific cloud platform. Our vision is a world where the software we build increases medical practice success and improves patient outcomes. Founded in 2010 by Daniel Cane and Dr. Michael Sherling, we have grown to over 3400 combined direct and contingent team members serving eleven specialties, and we are just getting started! ModMed is based in Boca Raton, FL, with office locations in Santiago, Chile, Berlin, Germany, Hyderabad, India, and a robust remote workforce with team members across the US.


ModMed is hiring a RCM Quality assurance lead  to join our positive, passionate, and high-performing quality team focused on best Quality practices. 

Your Role:

The Quality Assurance Supervisor role will work closely with Global Partners and the COE Team to monitor and address quality-related gaps. They will also ensure that deliverables from the respective teams meet the required quality standards.

Responsibilities:

  1. Communicate with Global Teams and provide Audit Outcomes for the work audited by the auditors within their Team and by MMI Auditors. Proactive communication across the Teams along with data points  is a key responsibility. They will use Jira, Quality Dashboards and focused presentations for the same.
  2. Global Teams provide Audit rebuttals. Quality Supervisors review those and respond with a decision to Global Teams. They will calibrate with the Delivery Teams in order to reduce the rebuttals to the minimum possible to avoid rework.
  3. Work on all Jira Tickets tagged to them for the quality concerns by Modmed Teams for their book of business( assigned Partners/specialties). They will work and resolve those within TAT
  4. Audit the Claims where Global Partners tagged those as uncollectible and provide feedback/ approval to write off as per the Modmed guidelines. 
  5. Pick up projects to audit the auditors and have a focused quality review to ensure that DPU frontend quality is > 98% and backend quality is > 95%
  6. Supervise the Quality Auditors and provide regular updates. They have to ensure that Quality Auditors are meeting the daily productivity targets. They will keep a very close eye on the issues reported by the Clients and internal Teams and will ensure that the gaps are identified and permanently fixed within defined timelines both proactively and reactively.
  7. Ensure that all the Quality improvement levers are being worked on and delivered in a timely manner, as per the Quality Strategy. The issues identified and reported are being fixed through a focused plan within defined timelines.
  8. Keep abreast of all the Process documentation and instructions  to make sure that the audits are in line with the processes laid down. They will have a strong understanding on the quality expectations for all the roles under their preview.


Skills & Requirements:

  • Require 8 years of experience in RCM Domain in AR and above with at least 2-3 years as Quality supervisor leading  a team of 5+ auditors in provider RCM . A hands-on Leader who is a SME in Quality Processes.


    1. Strong knowledge of Quality Processes 
    2. Proven Track record of creating and implementing CAPA plans 
    3. Highly skilled in DISCOVERY of issues related with Quality 
    4. Strong Communication - Writing as well as oral
    5. Expert in Advanced Excel and PPTs

    Preferred Certification in Quality Processes such as Six Sigma, TQM etc.

ModMed in India Benefit Highlights:

  • High growth, collaborative, transparent, fun, and award-winning culture
  • Comprehensive benefits package including medical for you, your family, and your dependent parents.
  • The company supported community engagement opportunities along with a paid Voluntary Time Off day to use for volunteering in your community of interest
  • Global presence, and in-person collaboration opportunities; dog-friendly HQ (US), Hybrid office based roles and remote availability, 
  • Company-sponsored Employee Resource Groups that  provide engaged and supportive communities within ModMed

ModMed Benefits Highlight:

At ModMed, we believe it’s important to offer a competitive benefits package designed to meet the diverse needs of our growing workforce. Eligible Modernizers can enroll in a wide range of benefits, including:

  • Comprehensive medical, dental, and vision benefits, including a company Health Savings Account contribution,
  • 401(k):  ModMed provides a matching contribution each payday of 50% of your contribution deferred on up to 6% of your compensation. After one year of employment with ModMed, 100% of any matching contribution you receive is yours to keep.
  • Generous Paid Time Off and Paid Parental Leave programs,
  • Company paid Life and Disability benefits, Flexible Spending Account, and Employee Assistance Programs,
  • Company-sponsored Business Resource & Special Interest Groups that provide engaged and supportive communities within ModMed,
  • Professional development opportunities, including tuition reimbursement programs and unlimited access to LinkedIn Learning,
  • Global presence and in-person collaboration opportunities; dog-friendly HQ (US), Hybrid office-based roles and remote availability for some roles,
  • Weekly catered breakfast and lunch, treadmill workstations, Zen, and wellness rooms within our BRIC headquarters.
The Company
HQ: Boca Raton, FL
1,153 Employees
On-site Workplace
Year Founded: 2010

What We Do

ModMed is transforming healthcare by placing doctors and patients at the center of care through an intelligent, specialty-specific cloud platform. With our electronic health records (EHR) and practice management (PM) systems, and our revenue cycle management (RCM) services, our all-in-one solution empowers specialty medical practices to do their best work by providing them with clinical, financial and operational software solutions designed to enable better, more personalized patient care. Our staff physicians help to develop products and services for dermatology, gastroenterology, ophthalmology, orthopedics, otolaryngology, pain management, plastic surgery, podiatry and urology practices, as well as ambulatory surgery centers. For more information, visit www.modmed.com.

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