RCM & Credentialing Quality Assurance Analyst – USA

Citadel Healthcare Management (PVT) LTD. provides healthcare management services for practices across North America. Our dedicated team supports a wide range of medical administration tasks working collaboratively across multiple disciplines.

Our mission is to offer employees meaningful opportunities to apply their expertise grow in their careers and contribute to the organizations ongoing success.

We are committed to creating a workplace where employees feel valued supported and motivated. By fostering a collaborative and engaging environment we ensure that every contribution is recognized and appreciated.

At Citadel diversity and inclusion are at the heart of our culture. We welcome individuals from all backgroundsregardless of gender ethnicity age religion lifestyle or disabilityand embrace the unique perspectives and experiences they bring. Through teamwork innovation and continuous professional development we empower our employees to thrive and drive progress within the organization.

Essential Duties and Responsibilities:

• Perform daily auditing of RCM accounts worked by staff to ensure accuracy based on QA policies and procedures

• Review credentialing files for accuracy completeness and compliance with state/federal regulations and internal policies

• Enter update and maintain or audit provider data within credentialing databases and tracking systems

• Gather and document general documentation issues for educational feedback purposes

• Maintain QA findings and complete monthly summary reports based on daily audit results and distribute them to management

• Communicate quality deficiencies to staff and provide detailed feedback where necessary

• Identify and trend recurring errors and report them to management to support training and process improvement

• Work closely with department management to review and improve workflows and ensure account resolution efficiency

• Assist in the training of new staff related to QA policies and procedures

• Report payor issues system issues or staff-related issues to management

• Respond to inquiries from other departments as needed

• Ensure compliance with information systems security policies attend required training and report any security concerns

• Adhere to the company code of conduct ethics policies and compliance requirementsincluding reporting any violations appropriately

• Complete QA summary files and support overall QA reporting processes

• Support company values and perform other duties as assigned