Revenue Cycle Management (RCM) Quality Assurance Contractor

Employment Type: Full-Time Location Type: Remote Salary: Not Specified

Position Overview

We are seeking an experienced Revenue Cycle Management (RCM) Quality Assurance Contractor to support our healthcare operations team. This fully remote role requires deep, hands-on experience across RCM workflows, including verification of benefits (VOB), prior authorizations, and claims, as well as a strong track record in quality assurance or auditing functions within healthcare.

Responsibilities

• Conduct QA reviews and audits of RCM workflows (VOB, prior authorization, claims submission, and follow-up).
• Identify errors, trends, and compliance risks, and provide actionable insights.
• Maintain detailed QA documentation and support process tracking and improvement.
• Collaborate with cross-functional teams to implement changes based on audit findings.
• Contribute to the development and refinement of SOPs, QA protocols, and reporting tools.

Requirements

• 3+ years of hands-on RCM experience, including VOB, prior auth, and claims.
• Previous experience in QA, auditing, or training within a healthcare operations setting.
• In-depth knowledge of payer rules, claims workflows, and revenue cycle operations.
• Strong attention to detail, excellent documentation skills, and a proactive mindset.
• Must be U.S.-based and authorized to work in the U.S.

Preferred Qualifications

• Background in tech-enabled healthcare or high-growth startups.
• Familiarity with HIPAA and healthcare compliance standards.
• Experience in MSO, DSO, or specialty medical billing environments.

Application Instructions

• Not Specified