Quality Specialist (US Healthcare) – Non-Voice - Coimbatore
CoimbatoreFull Time
CLAIMS AUDIT
DENIAL MANAGEMENT
HEALTHCARE OPERATIONS
HIPAA COMPLIANCE
MEDICAL CLAIMS
QUALITY
Job description
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
Skills Required
Quality Specialist (US Healthcare) – Non-Voice - Coimbatore
Hospitals/ Health Care
Bachelor Degree
Full Time, Permanent
Key Skills
- CLAIMS AUDIT
- DENIAL MANAGEMENT
- HEALTHCARE OPERATIONS
- HIPAA COMPLIANCE
- MEDICAL CLAIMS
- QUALITY
Other Information
GO/JC/1107/2025
Brindha Kamaraj
