The Process Excellence Manager is responsible for leading the Quality Assurance function across Intake, Billing, Accounts Receivable (AR), and Payment Posting processes within the SIS Revenue Cycle Services (RCS) Team. This role manages a team of QA Analysts/Leaders, drives process excellence through Lean/Six Sigma methodologies, and ensures compliance, accuracy, and continuous improvement in all QA activities. The PE Manager collaborates with cross-functional teams to develop and implement QA strategies, audit protocols, and training programs that support operational goals and regulatory requirements.
Essential Duties & Responsibilities
- Lead, mentor, and develop QA Analysts/Leaders for Intake, Billing, AR, and Payment Posting functions.
- Design, implement, and oversee comprehensive QA programs and audit protocols for all revenue cycle processes.
- Establish and monitor QA metrics, KPIs, and reporting standards to ensure process quality and compliance.
- Collaborate with Operations and RCS leadership to identify process gaps, recommend improvements, and drive corrective actions.
- Ensure timely and accurate audits of workflows, documentation, and system entries across all functions.
- Develop and maintain QA policies, procedures, and training materials.
- Facilitate regular team meetings, calibration sessions, and cross-functional reviews to align QA standards.
- Work closely with the Director of Process Excellence and present audit findings, quality trends, and training outcomes to leadership and cross-functional stakeholders.
- Escalate critical issues and trends to the Director of Process Excellence and other stakeholders.
- Drive endtoend process improvement initiatives using Lean and Six Sigma tools (DMAIC, RCA, control plans etc.,)
- Analyze audit trends to identify root causes and implement corrective and preventive actions (CAPA).
- Lead quality-driven process optimization across claim submission, charge capture, coding workflows, billing cycles, and AR follow-up strategies.
- Identify workflow bottlenecks and quality rework drivers; design sustainable, data-driven solutions.
- Collaborate with Product and Technology teams to recommend automation, system enhancements, and validation rules.
- Oversee root cause analysis for recurring denials, coding errors, and billing defects
- Support onboarding and ongoing training for QA staff; foster a culture of continuous learning and improvement.
- Stay current with industry best practices, regulatory changes, and technology advancements relevant to revenue cycle QA.
- Foster a culture of accountability, accuracy, compliance, and continuous improvement aligned with SIS values.
- Other duties as required to support team objectives
Quality Management System (QMS/ISMS) Oversight
- Ensure QMS and ISMS adherence in line with ISO 9001 and ISO 27001 standards
- Lead internal audits, risk assessments, management reviews, and compliance reporting for Noida
Qualifications
- Bachelor's degree/ Master's degree
- Six Sigma Black Belt trained/ certified preferred
- 10+ years of experience in healthcare revenue cycle operations, with at least 2 years in a QA leadership role.
- Proven experience managing QA teams and implementing audit programs in Intake, Billing, AR, and Payment Posting.
- Strong analytical skills, attention to detail, and ability to interpret complex data.
- Excellent organizational, communication, and leadership skills.
- Proficiency with Microsoft Office (Excel, Word, PowerPoint) and revenue cycle management systems (e.g., SIS, Waystar).
- Ability to work collaboratively across teams and manage multiple priorities in a fast-paced environment.
- Commitment to process excellence, compliance, and customer service.
Key Competencies
- Leadership & Team Development
- Quality Assurance & Audit Expertise
- Process Improvement
- Communication & Collaboration
- Analytical Thinking
- Organization & Time Management
