Manager/Senior Manager - Business Excellence - Healthcare RCM Provider

A prestigious client of Innoquest Consulting, a BPM service provider in the healthcare sector, is seeking Quality Professionals (Black Belt certified) in the RCM domain to be based in Hyderabad.

Skills required :

- Six Sigma Black belt certified is a must

- Monitor RCM workflows across stages (e.g., pre-registration, charge entry, coding, billing, A/R follow-up) to ensure adherence to SOPs and standards.

- Conduct transactional audits to verify accuracy of data entry, coding (ICD, CPT), and claims processing.

- Validate that billing aligns with payer-specific rules and compliance standards (e.g., HIPAA, CMS).

- Ensure compliance with healthcare regulations, payer policies, and legal requirements.

- Conduct Root Cause Analysis (RCA) of recurring errors or denials.Lead Corrective and Preventive Action (CAPA) initiatives to improve claim accuracy and reduce rework.

- Collaborate with IT or automation teams to enhance system workflows.

Qualification :

- Around 10 years of experience in international BPO Business

- Around 4-5 years in Business Excellence/process improvement roles with proven track record for transformation projects.

- Work experience in MNCs or reputed organizations will be an added advantage.

- Prior Experience of transformational projects impact end customer will be an advantage