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Guidehouse

Advises agencies and runs regulated operations

Quality Analyst

Internal Audit & ControlsConfirmed live in the last 24 hours
Full-timeChennai, Tamil Nadu, IndiaNo salary listedIn-person

About the Job

Requirements

  • Strong knowledge of United States Healthcare Revenue Cycle Management.
  • Strong understanding of Authorization and Notification on Admission workflows, backed by relevant hands-on experience.
  • At least 3 years of experience in United States Healthcare Revenue Cycle Management.
  • Strong analytical, problem-solving, and attention-to-detail skills.
  • Good communication skills with the ability to provide clear, constructive feedback.
  • Prior experience in a Quality Assurance or Auditor role.
  • Willingness to work night shifts.
  • Any undergraduate degree is mandatory; diploma holders are not eligible.

Responsibilities

  • Conduct quality audits on inpatient and observation accounts requiring Notification on Admission, in line with sampling guidelines.
  • Validate accurate submission of notifications through portals, Electronic Data Interchange, fax, or calls, and ensure timely initiation of non-clinical authorizations.
  • Review documentation accuracy, including reference numbers, authorization numbers, payer timelines, and compliance requirements.
  • Perform root cause analysis on identified defects, develop Corrective and Preventive Action plans, and track recurring trends such as missed Notifications on Admission, delays, and documentation gaps.
  • Provide actionable feedback on audit findings, support process clarifications, lead performance-improvement discussions, and participate in periodic team reviews.
  • Prepare daily, weekly, and monthly quality reports, track service-level agreement and accuracy metrics, and contribute to governance reviews.
  • Participate in calibration sessions, refresher initiatives, and training programs to strengthen process quality.

Desired Qualifications

  • Prior experience in quality audits or quality assurance within United States Healthcare Revenue Cycle Management.
  • Exposure to multiple Revenue Cycle Management functions, including accounts receivable, denials, charge entry, and payment posting.
  • Experience in trend analysis, data interpretation, and quality reporting.
  • Familiarity with audit tools, scorecards, and quality metrics.
  • Knowledge of Health Insurance Portability and Accountability Act compliance and quality standards.
  • Ability to mentor team members and support performance-improvement initiatives.

About the Company

Guidehouse

Advises agencies and runs regulated operations

Guidehouse advises government agencies and companies in regulated industries on strategy, technology and day-to-day operations. Its work combines business advice with software implementation and ongoing management, so a client uses the same firm to plan a change, build the systems and run the resulting processes. Teams modernize cloud platforms, apply data analysis and artificial intelligence, and redesign organizations to meet operating and regulatory requirements. Clients pay for consulting projects and technology work or outsource continuing business functions to its managed services teams. Guidehouse was founded in 2018 and is headquartered in McLean, Virginia.

Company size
10,001+
Company stage
Acquired
Total funding
$750K
Headquarters
McLean, VA
Founded
2018

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