Quality Specialist

Job Title: Quality Specialist - Voice & Non Voice (US Healthcare Claims)

Experience: 4+ years in US Healthcare Claims Adjudication

Qualification: Any Graduate

Job Description:

We are hiring a Quality Specialist with expertise in US Healthcare claims adjudication. The role involves conducting audits, ensuring compliance, identifying errors, and driving process improvements using quality tools and methodologies.

Key Responsibilities:

• Perform quality audits for healthcare claims processing.
• Ensure compliance with client and regulatory requirements (HIPAA, CMS).
• Apply 7 QC tools, RCA, CAPA, and Six Sigma for error reduction.
• Prepare reports and share feedback with operations teams.
• Support process improvement initiatives to enhance accuracy and efficiency.

Mandatory Skills:

• US Healthcare claims adjudication knowledge.
• Quality audit and compliance expertise.
• Strong analytical and problem-solving skills.
• Good communication and documentation abilities.

Location: [Bengaluru]

If interested candidates send resume to [Confidential Information]

WhatsApp: 9789000298