Healthcare Operations | QA & Team Lead

Job Description Healthcare Operations | QA & Team Lead
Job Location

Hyderabad

Experience

4+ years in US Healthcare / Revenue Cycle Management (RCM)

Roles Covered
Quality Analyst Prior Authorization
Quality Analyst Accounts Receivable (AR)
Team Coach / Team Lead Prior Authorization
Team Lead Accounts Receivable (AR)
Job Summary

We are looking for experienced healthcare professionals with strong knowledge of US Healthcare RCM processes, particularly Prior Authorization and Accounts Receivable (AR). The ideal candidates should have hands-on process expertise along with strong quality, team-handling, communication, and performance-management skills.

Key Responsibilities
For Quality Analyst Prior Authorization / AR
Conduct quality audits for Prior Authorization or AR processes.
Review transactions/calls/cases for process and quality compliance.
Identify errors, process gaps, and areas for improvement.
Provide detailed feedback and coaching to team members.
Prepare and maintain quality reports and audit trackers.
Ensure adherence to client requirements, SOPs, and quality standards.
Coordinate with operations and training teams to improve overall performance.
Support root-cause analysis and corrective action plans.
For Team Coach / Team Lead Prior Authorization / AR
Manage and monitor a team of approximately 78 members.
Ensure achievement of daily, weekly, and monthly operational targets.
Monitor team productivity, quality, attendance, and performance.
Conduct regular coaching and feedback sessions.
Handle escalations and resolve process-related issues.
Ensure adherence to SOPs, compliance requirements, and client guidelines.
Track team performance and prepare MIS/reports.
Identify training requirements and coordinate with relevant teams.
Drive process improvements and maintain operational efficiency.
Work closely with QA, training, and management teams.
Required Skills
Strong knowledge of US Healthcare / RCM processes.
Prior experience in Prior Authorization and/or AR.
Good understanding of healthcare claims, insurance, payer processes, and workflows.
Strong analytical and problem-solving skills.
Excellent verbal and written communication.
Good knowledge of MS Excel and reporting/MIS.
Strong team-handling and people-management skills for TL/Coach positions.
Ability to work in a target-driven and process-oriented environment.
Eligibility
QA roles: Minimum 4 years of relevant experience.
Team Coach / TL roles: 46+ years of relevant experience, with prior team-handling experience preferred.
Candidates with experience handling 78 members will be preferred for Team Coach/TL positions.
Candidates with relevant healthcare RCM experience and stable employment history are preferred.
Work Location

Hyderabad, including Shamshabad for applicable positions.

Additional Requirement

Candidates should be comfortable working in a US Healthcare process and in rotational/night shifts, if required.