Note: The job is a remote job and is open to candidates in USA. Nimble Solutions provides revenue cycle outsourcing services to healthcare organizations, including ambulatory surgery centers, surgical practices, surgical hospitals, and anesthesia groups. The Quality Manager, Accounts Receivable will manage quality assurance frameworks across Accounts Receivable processes, lead monitoring and continuous improvement initiatives, analyze performance and customer feedback, and partner with Operations and Training teams to improve compliance, productivity, collections, and client satisfaction.
Responsibilities
- Implement and continuously improve quality monitoring guidelines and audit methodologies across all Lines of Business (LOBs)
- Develop audit scorecards, quality forms, and evaluation criteria aligned with client expectations and business priorities
- Ensure quality audits are conducted accurately, consistently, and within established timelines
- Monitor process adherence and identify deviations, risks, and compliance gaps
- Conduct calibration sessions with Operations, Quality, and Leadership teams to ensure consistency of evaluations
- Ensure all operational teams are calibrated on audit guidelines and remain compliant with established audit processes
- Partner with Operations leadership to improve key operational metrics through targeted interventions and performance improvement plans
- Drive continuous improvement initiatives utilizing Six Sigma, Lean, Total Quality Management (TQM), ISO standards, and other quality methodologies
- Identify opportunities to reduce defects, improve first-time quality, increase throughput, and eliminate non-value-added activities
- Lead root cause analysis (RCA) and corrective and preventive action (CAPA) initiatives to eliminate recurring errors
- Support process owners in implementing customer VOC-driven improvements
- Measure, analyze, and report quality performance metrics across Accounts Receivable operations and other assigned LOBs
- Provide actionable insights through quality dashboards, trend analysis, and executive reports that influence operational decisions through data-drive recommendations thereby enhancing process effectiveness and financial performance
- Conduct deep-dive analyses to identify factors impacting productivity, denial rates, aging, rework, and revenue realization
- Present business-focused quality reviews and performance insights to senior leadership and operational stakeholders
- Track and monitor key quality indicators including: Accuracy; Compliance; Productivity; First Pass Yiel; Customer Satisfaction; Defect Rates; Rework Trends; Revenue Leakage Indicators
- Ensure data-driven decision-making through meaningful reporting and analytics
- Participate in the development and maintenance of risk management tools and controframeworks
- Identify operational risks and implement mitigation strategies to maintain quality and compliance standards
- Support internal and external audits as required
- Develop a high-performing quality team
- Coach team members on quality methodologies, analytical techniques, and process excellence principles
- Conduct quality calibration sessions and performance improvement discussions
- Support Operations and Training teams during hiring, onboarding, and capability-building initiatives
- Foster a culture of continuous learning, innovation, accountability, and customer-centricity
- Guide teams to proactively identify improvement opportunities and enhance productivity
- Work closely with Operations Managers, Client Services, Training, and Leadership teams to improve overall AR performance
- Participate in performance reviews and operational governance meetings to ensure quality insights are translated into action
- Support Operations in identifying workflow bottlenecks, process inefficiencies, training gaps, and compliance risks
- Conduct root cause analysis (RCA) and lead corrective action programs to address recurring errors and performance gaps
- Ensure quality initiatives directly contribute to improved collections performance, reduced denials, higher productivity, and enhanced client satisfaction
Skills
- Proven track record as a Quality Assistant Manager in a service delivery environment
- Strong understanding of Revenue Cycle Management and Accounts Receivable operations
- Thorough knowledge of quality assurance methodologies and industry standards
- Expertise in Six Sigma, Lean, Kaizen, TQM, CAPA, and Process Excellence frameworks
- Strong knowledge of quality control procedures and operational compliance requirements
- Experience designing quality scorecards, audit frameworks, and quality measurement systems
- Advanced analytical and problem-solving skills
- Proficiency in MS Office Suite (Excel, PowerPoint, Word)
- Experience with reporting tools, databases, quality analytics, and dashboard development
- Strong knowledge of process mapping, RCA tools, and statistical analysis techniques
- Proven ability to translate quality findings into operational and financial improvements
- Strong stakeholder management and influencing skills
- Bachelor's Degree in any discipline (BSC, Life Sciences, Healthcare Administration or related field preferred)
- 8–10 years of experience in Healthcare Revenue Cycle Management with a focus on Accounts Receivable operations
- At least 3–5 years of experience managing Quality Assurance or Quality Management functions within AR processes
- Demonstrated expertise in denial management, insurance follow-up, payment posting validation, appeals management, quality audits, and process improvement
- Strong analytical, stakeholder management, reporting, and team leadership skills
- Experience working with US healthcare providers, payers, and RCM performance metrics
- Lean Six Sigma Black Belt or equivalent quality certification is an added advantage
Company Overview