Quality Lead – Medical Billing

Location:

Remote

Position Overview The Quality Lead will be responsible for ensuring high standards of quality across the Medical Billing/Processing team. This role involves conducting audits, analyzing trends, implementing preventive measures, and driving continuous improvement initiatives. The Quality Lead will also provide hands-on support during peak cycles, manage coordinators, and ensure seamless delivery of client parameters and SLAs.

Key Responsibilities  Establish and maintain quality standards for the Billing/Processing team.
Conduct concurrent and retrospective audits, documenting and reporting findings professionally.
Analyze performance trends and error patterns.
Initiate preventive actions to mitigate recurring issues.
Perform root cause analysis of errors and process gaps.
Recommend and implement process improvements to enhance efficiency and accuracy.
Review errors with individuals on a daily/weekly basis.
Provide targeted training to team members committing repetitive errors.
Assist with regular Billing/Processing timesheet work during BP cycles, if required.
Manage coordinators to ensure seamless workflow execution.
Monitor and ensure adherence to client parameters and SLAs.
Leverage quality management tools (e.g., Six Sigma, Lean, Kaizen, PDCA cycle, Pareto analysis, Fishbone diagrams) to identify process gaps and drive structured improvements.
Implement and monitor KPIs, dashboards, and control charts to track performance and ensure compliance with quality standards.

Qualifications & Skills  Bachelor’s degree.
Proven experience in quality assurance, process audits, or operations management in US healthcare- medical billing or RCM.
Hands-on experience with quality management concepts and tools such as Six Sigma methodologies, Lean practices, ISO standards, and statistical process control.
Strong analytical and problem-solving skills.
Excellent communication and interpersonal skills for training and error review.
Ability to manage teams and coordinate across functions.
Proficiency in MS Office tools and familiarity with Billing/Processing systems.
Experience in Medical Billing processes.
Competencies  Detail-oriented with a focus on accuracy.
Strong leadership and mentoring abilities.
Proactive in identifying risks and implementing preventive measures.
Ability to work under pressure during peak cycles.
Commitment to continuous improvement and client satisfaction.
Ability to apply structured quality frameworks and data-driven decision-making to achieve operational excellence.

Shift Timings

3PM to 12 Midnight IST