AR Quality Analyst – Cardiology RCM

Hello Connections,

Greetings from Eclat Health !!!

We are Hiring for Quality Auditor AR for our Hyderabad Facility.

Role Summary

We are looking for a Quality Analyst (QA) Cardiology RCM with strong expertise in Accounts Receivable (AR) processes, cardiology coding, and denial management. The candidate will be responsible for ensuring high-quality claim handling, minimizing rework, and improving overall process efficiency.

Key Responsibilities

1. Quality Auditing & Error Detection

• Perform detailed audits of AR worked claims
• Validate denial reasons and resolution accuracy
• Ensure complete account-level resolution (not just claim-level)
• Review correctness of payment posting, adjustments, and write-offs
• Ensure follow-ups (appeals, corrected claims) align with payer guidelines

2. Cardiology Coding & Compliance

• Verify CPT & ICD-10 coding accuracy based on documentation
• Ensure proper use of modifiers (e.g., -26, -59)
• Identify and prevent unbundling issues
• Demonstrate knowledge of common cardiology procedures & codes
• Handle appeals with strong clinical justification

3. Denial Analysis & Process Improvement

• Identify denial trends across payers (e.g., Medicare, Commercial)
• Analyze medical necessity denials (EKG, Stress Tests, Cath procedures)
• Recommend front-end improvements (authorization, registration)
• Work towards reducing Days in AR and rework rate

4. Training & Quality Ownership

• Provide feedback and coaching to AR teams
• Develop training materials/cheat sheets for cardiology billing
• Take ownership of team quality metrics
• Lead discussions on client calls along with TLs

Required Skills & Knowledge

• Strong understanding of Cardiology RCM end-to-end process
• Expertise in Medical Necessity & LCD guidelines
• Knowledge of payer policies (Medicare & Non-Medicare)
• Hands-on experience with Excel (Pivot, VLOOKUP)
• Familiarity with tools like Epic / eClinicalWorks / NextGen / EDI
• Strong knowledge of cardiovascular anatomy & terminology
• Experience in quality tools & audit frameworks

Eligibility Criteria

• Experience: 4 to 8 years in AR Follow-up (12 years in Cardiology QA preferred)
• Education: Science Graduate
• Current Designation : Quality Analyst on papers is Mandatory

Key Performance Indicators (KPIs)

• Reduction in rework rate
• Improvement in quality scores
• Reduction in Days in AR
• Accuracy in audits and reporting

Eligible profiles can write to vinaykumar.chenoji@eclathealth.com / shruthi.vakulabharanam@eclathealth.com

Contact HR – Vinay – WhatsApp – 7893217519

Contact HR – Shruthi – WhatsApp – 7032220717

Regards

HR Team

Eclat Health Solutions India Pvt ltd

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