Quality Assurance Team Lead

Job Description

Our client is seeking an experienced and results-driven Quality Assurance Team Lead to supervise and strengthen the QA function across US Healthcare Revenue Cycle Management (RCM) operations.

Key Responsibilities

• Lead and supervise day-to-day QA activities across multiple RCM processes, ensuring adherence to quality standards, client SLAS and business objectives.
• Oversee quality audits, audit sampling, evaluations and calibration sessions to ensure accuracy, consistency and compliance.
• Monitor team and individual quality performance, identify recurring errors, and ensure timely corrective and preventive actions.
• Conduct root cause analyses to identify process gaps and recommend improvement initiatives.
• Develop and maintain QA guidelines, audit checklists, SOPs and quality documentation.
• Identify opportunities to leverage automation and Al-enabled solutions to improve audit efficiency and accuracy.
• Monitor quality through dashboards, reports and analytics, providing actionable insights to management.
• Ensure adherence to HIPAA, CMS guidelines, payer requirements and internal quality standards.
• Lead, coach and develop QA team members, ensuring productivity and continuous improvement.
• Collaborate with Operations, Training, Compliance, Technology and Analytics teams.
• Participate in client quality reviews and governance meetings, presenting findings and recommendations.
• Support the QA Manager in implementing quality strategies and continuous improvement initiatives.

Qualifications & Experience

• Bachelor's degree in Healthcare Management, Business Administration or a related discipline.
• 5+ years of experience in US Healthcare RCM, with at least 3+ years in Quality Assurance.
• Minimum 3 years of team leadership or supervisory experience, preferably within a healthcare RCM environment.
• Strong knowledge of key RCM functions, including Medical Billing, Accounts Receivable (AR) Management, Denial Management, Payment Posting and Medical Coding.
• Good understanding of US healthcare regulations, including HIPAA, CMS guidelines and payer-specific compliance requirements.
• Proven experience in quality audits, audit calibration, root cause analysis, corrective action planning and process improvement.
• Exposure to Lean, Six Sigma or other continuous improvement methodologies.
• Experience or exposure to automation, Al-enabled solutions or digital transformation initiatives is an added advantage.
• Proficiency in data analysis and reporting tools such as Advanced Excel, Power BI or Tableau.
• Professional certifications such as CPC, CCS, CRCP, Lean Six Sigma or equivalent qualifications will be an added advantage.
• Strong leadership, communication, analytical, problem-solving and stakeholder management skills.