Operations

• Conduct comprehensive QA testing on billing rules and logic within the RCM system to ensure compliance, accuracy, and efficiency.
• Utilize advanced SQL techniques to extract, manipulate, and validate large datasets, ensuring data integrity and accuracy in rule testing and issue resolution.
• Utilize Python to automate data processing, build models, and perform complex analyses; write reusable and efficient code to improve data workflows.
• Analyze billing transactions, rejections, and denials data to identify patterns, discrepancies, and areas for optimization.
• Work closely with cross-functional teams to refine and enhance billing automation rules, ensuring alignment with industry best practices and compliance standards.
• Develop and maintain detailed documentation of test cases, findings, and resolutions to support continuous process improvements and knowledge sharing within the team.
• Provide actionable insights and recommendations based on data analysis to optimize claim acceptance rates and streamline billing workflows.
• Proactively identify system inefficiencies and collaborate with stakeholders to implement innovative solutions that drive operational excellence.
• Operate on the night shift schedule (10:00 pm-7:00 am, Monday to Friday) as specified.

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