Company Description Cascade Revenue Management, an AIMA Group company, is part of AIMA BMS, a global IT-ITES service provider supporting clients from small businesses to Fortune 500 organizations. With offices in Sarasota (FL), Toronto (ON), London (UK), and Kochi (India), the group delivers technology, digital marketing, and business process services across multiple markets and time zones. Cascade Revenue Management, established in 2015, offers software development and maintenance, SEO and digital marketing services, and comprehensive software quality assurance. The company also provides a full suite of Revenue Cycle Management (RCM) services, including scheduling, insurance verification, claims processing, denial management, and account resolution. In addition, Cascade supports clients with back-office BPO and eCommerce services such as catalog management, data entry, customer care, and technical support.
Position Summary
The AR Quality Auditor (AR EQA) is responsible for conducting post-process quality audits on Accounts Receivable (AR) operations to ensure compliance with client requirements, internal quality standards, and industry best practices. The role focuses on identifying process deviations, providing feedback, performing root cause analysis, and supporting continuous quality improvement initiatives across AR operations.
Key Responsibilities
- Perform post-process quality audits on completed Accounts Receivable (AR) transactions.
- Ensure compliance with client SOPs, payer guidelines, HIPAA requirements, and internal quality standards.
- Identify quality defects, documentation gaps, and process deviations during audits.
- Complete assigned audits accurately within defined turnaround times (SLAs).
- Prepare audit reports and provide detailed feedback to Operations Managers and Team Leads.
- Conduct root cause analysis (RCA) for recurring quality issues and recommend corrective actions.
- Monitor quality trends and contribute to continuous process improvement initiatives.
- Participate in calibration sessions to maintain audit consistency across the Quality team.
- Support training and coaching by highlighting common error trends and knowledge gaps.
- Maintain confidentiality and comply with organizational information security policies.
Educational Qualification
Mandatory: Any Bachelor's Degree.
Preferred: Degree in Life Sciences, Healthcare Administration, or related field is an added advantage.
Experience
- Minimum 4+ years of experience in the Revenue Cycle Management (RCM) industry.
- Minimum 1 year of hands-on experience in AR Quality Auditing.
Technical Skills Required
- Strong knowledge of Accounts Receivable (AR) processes.
- Understanding of Medical Billing and Revenue Cycle Management workflows.
- Knowledge of Denial Management, Appeals, Insurance Follow-up, and Collections.
- Working knowledge of CPT, ICD-10, HCPCS, modifiers, and payer guidelines.
- Experience with quality audit methodologies and scoring mechanisms.
- Good knowledge of Microsoft Excel and reporting tools.
Core Competencies
- Excellent attention to detail and analytical thinking.
- Strong problem-solving and decision-making skills.
- Effective written and verbal communication.
- Ability to provide constructive feedback professionally.
- Time management and ability to meet audit deadlines.
- Team collaboration and stakeholder management.
Eligibility Criteria
- Minimum 4 years of experience in Medical Billing / RCM.
- Minimum 1 year of AR Quality Auditing experience.
- Strong understanding of AR workflows and payer guidelines.
- Excellent communication and documentation skills.
- Proficiency in Microsoft Excel and reporting.