RCM Quality Assurance Specialist

 Posted an hour ago
  
 India
  
5-10 years experience
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AI Summary

The specialist is responsible for auditing claim work and AI agent outputs to ensure accuracy and documentation quality. They will develop QA scorecards, identify error patterns, and provide coaching to billing associates to improve performance.

About Amperos Health

Amperos Health is healthcare's first AI-native denial management and revenue recovery platform. Our agentic AI works claims end-to-end, from portal follow-ups and payor calls to appeals and medical records, so providers can resolve more denials, recover more revenue, and focus on what matters most: serving patients.

We just closed a $16M Series A led by Bessemer Venture Partners, with continued participation from Uncork Capital and Neo. We're still small, still early, and going after a $260B+ problem that's only getting worse. If you want to work on hard problems that matter, alongside people who care deeply about the mission (and each other), we'd love to meet you.

About the Role

The RCM QA Specialist owns the quality of work produced by both our billing associates and our AI agents. You will audit claim work for accuracy, evaluate outputs against the source of truth, and turn what you find into coaching, process fixes, and scalable quality checks. As our AI capabilities grow, this role becomes central to making sure both humans and machines hit the standard our clients expect.

What You'll Do

  • Audit claim work for action accuracy, claim-issue accuracy, and documentation quality, following our QA process

  • QA agent outputs across calls, payer portals, and denial workflows, comparing logged results to the source of truth and flagging error patterns and drift

  • Build and maintain QA scorecards, trackers, and dashboards in Excel or Sheets, and help shape reporting in our BI tools

  • Design automated or rule-based quality checks that catch recurring errors before they require manual review

  • Identify the root causes behind error trends and translate them into specific coaching for billing associates and Team Leads

  • Surface AI error patterns to Product and Engineering with reproducible, claim-level detail

  • Calibrate QA standards across reviewers, maintain QA rubrics, and support our critical-error-free rate target

  • Track appeal and overturn outcomes and other quality KPIs

What We're Looking For

  • 4+ years in RCM, AR follow-up, or denial management with a demonstrated record of high accuracy and strong production

  • Advanced Excel or Google Sheets skills (pivot tables, lookups, conditional logic) and genuine comfort working with data

  • A pattern-finder who looks for root cause, not just pass or fail

  • Detail-oriented and organized, able to document quality standards clearly

  • Comfortable evaluating AI-generated work and giving structured, actionable feedback

  • Able to work US hours (9am to 6pm ET)

Nice to Have

  • SQL or experience querying claim data directly

  • Experience with BI or analytics tools (Looker, Tableau, Metabase)

  • Experience building QA automation or rule-based quality checks

  • Exposure to ModMed, NextGen, Athenahealth, or similar PM systems

Our Values

  • Lead with Empathy - Great products and teams are built on empathy—whether for our customers, users, or team members. We take the time to walk in others' shoes, listen actively, and truly understand their challenges, needs, and perspectives.

  • Humbly Ambitious - We combine humility with ambition. No task is beneath us, and no challenge too big. Greatness comes from being willing to do whatever it takes, while having the courage to take bold risks and learn from failures.

  • Radical Agency - Own your domain. Drive initiatives with autonomy and accountability. Think deeply, communicate with the team, and maintain a bias for action.

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