RCM QA Specialist

About the role

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 outco mes. 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. 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.

Responsibilities

• 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.
• 4+ years of total RCM experience is preferred, with at least 1 year specifically in an auditing role.
• Experience: * A minimum of 3 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 suppo

Benefits

Additional Information

Join the Team Modernizing Medicine At ModMed , we're not just building software-we're reimagining the healthcare experience. Founded in 2010 by a practicing physician and a successful tech entrepreneur, we took a radically different approach: we hired doctors and taught them how to code. This "for doctors, by doctors" philosophy has allowed us to create an AI-enabled, specialty-specific cloud platform that places patients at the center of care. A Culture of Excellence When you join ModMed, you're joining an award-winning team recognized for innovation and employee satisfaction. From our global headquarters in Boca Raton Florida, and extensive employee base in Hyderabad India, we are a team of 4,500+ passionate problem-solvers on a mission to increase medical practice success and improve patient outcomes: Consistently ranked as a Top Place to Work 2025 Globee Business Awards: Gold Globee for "Technology Team of the Year" 2025 Black Book Awards: Ranked #1 EHR in 11 Specialties Florida Venture Forum: Venture-Backed Company of the Year We are growing fast, thinking big, and we are just getting started. Ready to modernize medicine with us? Job Description Summary: RCM QA Specialist Location: Hyderabad Department: Revenue Cycle Management (RCM) Reports to: Team Manager, Quality Assurance

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