
Quality Specialist
4 weeks ago
Job Title: Quality Specialist (US Healthcare) – Non-Voice - Coimbatore
Job Overview: We are seeking a detail-oriented and experienced Quality Specialist with a strong background in US Healthcare processes, specifically in claims adjudication. This is a non-voice role focused on ensuring accuracy, compliance, and continuous improvement in healthcare claim processing. The ideal candidate will bring analytical rigor, process knowledge, and a passion for quality assurance.
Key Responsibilities:
Conduct audits of healthcare claims to ensure accuracy and compliance with US healthcare regulations and payer guidelines
Identify trends, errors, and areas of improvement in claims adjudication processes
Collaborate with operations and training teams to address quality gaps and implement corrective actions
Prepare and present audit reports, dashboards, and performance metrics
Maintain documentation of audit findings and follow-up actions
Support process improvement initiatives and contribute to SOP updates
Ensure adherence to HIPAA and other regulatory standards
Skills & Attributes:
Minimum 3.6 years of experience in US healthcare domain, with at least 1 year as a Quality Analyst
Strong understanding of claims adjudication workflows and terminologies
Excellent analytical and problem-solving skills
Proficiency in MS Excel, audit tools, and reporting platforms
Ability to work independently in a fast-paced, deadline-driven environment
Strong written communication skills (non-voice role)
Familiarity with HIPAA compliance and payer-specific guidelines
Interested candidate can share updated resume to
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