Healthcare Quality Analyst Healthcare BPO

About This Role

Working as a Healthcare Quality Analyst in the Business Process Outsourcing (BPO) team, you will ensure that healthcare processes meet compliance standards, deliver high service quality, and align with client expectations. This role suits a detail-oriented and analytical candidate with strong knowledge of healthcare operations, quality assurance methodologies, and regulatory requirements.

Responsibilities

• Review and audit healthcare transactions, claims, and customer interactions for accuracy and compliance
• Identify gaps in process execution and recommend corrective actions
• Ensure adherence to HIPAA, data privacy, and other healthcare regulations
• Analyze performance metrics and trends to identify opportunities for efficiency and quality enhancement
• Collaborate with operations teams to implement best practices and process improvements
• Develop and maintain quality scorecards, reports, and dashboards
• Provide feedback and coaching to agents and teams based on audit findings
• Assist in designing training modules focused on compliance, accuracy, and customer service
• Support new process transitions by validating quality standards
• Maintain accurate records of audits, findings, and corrective actions
• Ensure compliance with client-specific guidelines and industry standards
• Participate in internal and external audits as required

Requirements

• Prior experience in healthcare BPO, quality assurance, or auditing roles
• Strong knowledge of healthcare processes (claims, billing, utilization review, medical coding)
• Familiarity with HIPAA and other healthcare compliance regulations
• Excellent analytical, communication, and problem-solving skills
• Proficiency in MS Office tools and quality monitoring systems