About the role

Responsibilities:

Perform data quality validation across RCM datasets, including Charges, Payments, Adjustments, Denials, and Accounts Receivable (A/R).
Conduct transaction-level reconciliation between PMS/EHR systems and downstream systems.
Identify and resolve data discrepancies, missing data, and inconsistencies.
Develop and execute SQL queries for data validation and root cause analysis.
Validate data transformations, mappings, and business rules.
Perform trend analysis and anomaly detection on key RCM metrics, including Denial Rate, A/R Days, and Collections.
Collaborate with cross-functional teams to define validation rules and acceptance criteria.
Maintain data quality dashboards, validation logs, and audit trails.
Support client onboarding and data validation cycles.
Document data issues, root cause analysis (RCA), and remediation steps.
Build reusable SQL-based validation scripts and frameworks for scalable data quality assurance (DQA).

Requirements:

4-8 years of experience in data QA or data validation, preferably in the healthcare RCM domain.
Strong understanding of RCM workflows, including billing, coding, payments, denials, and accounts receivable.
Hands-on expertise in SQL, including joins, aggregations, validation queries, and performance tuning.
Experience working with large-scale, transaction-level healthcare datasets.
Strong analytical, problem-solving, and attention-to-detail skills.
Experience with ETL testing, data validation frameworks, or data QA processes.
Ability to interpret business metrics and translate them into data validation logic.
Understanding of HIPAA compliance and healthcare data security standards.

Nice to Have:

Data Quality Analyst