RCM QA Specialist

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Job Description Summary:

Job Description

RCM QA Specialist

Location: Hyderabad

Department: Revenue Cycle Management (RCM)

Reports to: Team Manager, Quality Assurance

Who We Are

At ModMed, we are 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.

We live by our core values:

Create Customer Delight and Save Time.

Innovate Boldly, then make things happen.

Align Passion with Purpose.

Think Big. Have Fun. Do Good.

The Role

We are looking for an RCM QA Specialist to join our team. This role is essential to our mission, ensuring that our Revenue Cycle Management processes are accurate, compliant, and of the highest quality. You will be a guardian of our standards, auditing transactions and identifying opportunities for continuous improvement to ensure we are delivering the best possible outcomes for our clients.

What You’ll Do

As an individual contributor, you will focus on high-impact quality assurance activities that drive operational excellence:

Auditing & Compliance : Conduct detailed audits of transactions and call reviews to ensure strict adherence to company policies, regulatory guidelines, and payer requirements.

Feedback & Coaching : Provide direct, constructive verbal feedback during 1:1 sessions or team huddles to help colleagues improve and align with quality standards.

Discrepancy Documentation : Diligently identify and document errors or non-compliant practices using standard protocols.

Process Improvement & Innovation: Participate in FMEA (Failure Mode and Effects Analysis) sessions to identify root causes and propose data-driven improvement suggestions.

Collaboration: Partner with operations teams during calibration sessions to clarify audit guidelines and share knowledge.

Reporting: Create daily, weekly, and monthly audit reports to provide visibility into quality trends for internal teams.

Dispute Resolution: Respond to audit rebuttals in a timely manner, escalating complex issues to senior leadership when necessary.

What You Bring

Education: A Bachelor’s degree in any discipline is mandatory.

5+ years of total RCM experience is preferred, with at least 1 year specifically in an auditing role.

Experience: * A minimum of 4 years of experience in Revenue Cycle Management (RCM) is required.

Technical Skills: Proficiency in Basic Excel is required for data tracking and reporting.

Mindset: * Accountability: You take ownership of outcomes and hold yourself to high standards.

Communication: You can clearly express ideas and build trust across multiple sub-business units.

Customer Focus: You are dedicated to building positive relationships and delivering solutions that delight our customers.

Agility: You embrace change and see it as an opportunity for growth.

Why Join ModMed?

You’ll be part of a culture that values innovation and purposeful work. You will have the opportunity to directly impact the efficiency of medical practices, helping them spend less time on paperwork and more time with patients.

ModMed is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

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:

• Meals & Snacks: Enjoy complimentary office lunches & dinners on select days and healthy snacks delivered to your desk,
• Insurance Coverage: Comprehensive health, accidental, and life insurance plans, including coverage for family members, all at no cost to employees,
• Allowances: Annual wellness allowance to support your well-being and productivity,
• Earned, casual, and sick leaves to maintain a healthy work-life balance,
• Bereavement leave for difficult times and extended medical leave options,
• Paid parental leaves, including maternity, paternity, adoption, surrogacy, and abortion leave,
• Celebration leave to make your special day even more memorable, and company-paid holidays to recharge and unwind.

PHISHING SCAM WARNING: ModMed is among several companies recently made aware of a phishing scam involving imposters posing as hiring managers recruiting via email, text and social media. The imposters are creating misleading email accounts, conducting remote "interviews," and making fake job offers in order to collect personal and financial information from unsuspecting individuals. Please be aware that no job offers will be made from ModMed without a formal interview process, and valid communications from our hiring team will come from our employees with a ModMed email address (first.lastname@modmed.com). Please check senders’ email addresses carefully. Additionally, ModMed will not ask you to purchase equipment or supplies as part of your onboarding process. If you are receiving communications as described above, please report them to the FTC website.

ModMed Technologies India Private Limited follows a strict, merit-based and transparent recruitment process conducted only through official and authorized channels.

We do not:

Charge any fees, processing charges, or amount by any nomenclature, whether as a fee or deposit at any stage of the recruitment process;

Authorise any individual, employee, or third party to collect any such payments (regardless of nomenclature) to offer or facilitate or recruitment opportunities; or

Conduct hiring via informal messaging apps or personal email IDs.

All official communication is made only through verified channels, our website, and recognised recruitment platforms.

We strongly advise candidates not to share personal/financial information or make any payments in response to suspicious communications. Any such instances may be reported to us at hrcompliance@modmed.com .

ModMed Technologies India Private Limited will not be responsible for any loss arising from fraudulent or unauthorised communications.