Quality Specialist

5 days ago

Coimbatore, India Golden Opportunities Full time

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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