Quality Analyst – Remote (India)
Location: Remote, India | Category: Quality & Compliance | Employment Type: Full-Time
Company Overview:
Zealie is a rapidly growing Medical Billing Services company specializing in the Behavioral Healthcare industry. We partner with substance use disorder treatment centers, addiction recovery facilities, and mental health treatment centers to provide data-driven insights and revenue management solutions. Our proprietary technology enables clients to make strategic business decisions while improving patient care outcomes.
Role Overview:
Zealie is seeking a Quality Analyst (QA) to join our Quality and Compliance team. This role will oversee compliance and quality assurance across all Revenue Cycle Management (RCM) functions, including Billing, Coding, Collections, and related workflows. The ideal candidate will have strong analytical skills, a keen eye for compliance, and the ability to implement process improvements to ensure regulatory adherence and operational efficiency.
Key Responsibilities:
Auditing & Compliance Monitoring:
Conduct regular audits of RCM processes (Billing, Boost, VOB, MR, Posting, UR, Collections) to ensure accuracy and regulatory compliance.
Track and document audit results, highlighting areas for improvement and actionable insights.
Ensure adherence to payer requirements and federal/state regulations, including HIPAA and CMS guidelines.
Process Evaluation & Improvement:
Analyze workflows across RCM departments to identify inefficiencies and compliance risks.
Recommend and collaborate with managers on implementing process improvements that enhance accuracy and compliance while maintaining operational efficiency.
Quality Assurance & Reporting:
Monitor key performance indicators (KPIs) related to quality and compliance.
Generate detailed reports for management and leadership.
Ensure corrective actions are taken for any issues identified during audits or daily operations.
Training & Development:
Provide guidance and training to RCM staff on compliance standards, audit procedures, and quality improvement initiatives.
Assist in developing training programs to keep new hires and existing staff updated on best practices and regulatory requirements.
Collaboration & Communication:
Serve as a point of contact for compliance-related questions and dispute resolution with payers or regulatory bodies.
Collaborate with internal teams and external stakeholders to ensure alignment on compliance and quality goals.
Required Qualifications:
Bachelor’s degree in Healthcare Administration, Business, or related field preferred.
5–8 years of experience in quality assurance, auditing, or compliance in healthcare RCM or billing.
Strong understanding of payer requirements, federal and state regulations, and RCM industry standards.
Proficiency with EMR systems and compliance software (e.g., Kareo, NextGen, Athena).
Advanced skills in Google Workspace (Sheets, Docs, Drive) and other related software tools.
Preferred Qualifications:
Minimum 2 years of experience in behavioral health, substance abuse, or mental health treatment billing.
Certified Professional Coder (CPC) or Certified Healthcare Compliance Officer (CHCO) certifications preferred.
Knowledge of all levels of care (Detox, RTC, PHP, IOP, OP, Aftercare).
Understanding of medical necessity as it pertains to billing compliance, denials, and appeals.
Why Join Zealie:
Become part of a high-performing team dedicated to delivering compliance excellence and innovative billing solutions in behavioral healthcare. Your expertise will help ensure quality, accuracy, and regulatory adherence across RCM operations while supporting the growth and success of Zealie and our clients.
Apply Now:
Take the next step in your healthcare quality career and join Zealie to make a measurable impact in behavioral healthcare billing and compliance.
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