Job Role QA -Claim Adjudication Location Indore Shifts US Shift Both the way cab available 5 Days working Saturday Sunday fixed off Salary 5 5-6 LPA incentives allowance Experience Minimum 4 6 years of experience in claims adjudication with at least 1 year in a SME on papers Key Responsibilities Auditing Claims Reviewing adjudicated claims to verify the accuracy of decisions compliance with client guidelines and adherence to healthcare insurance standards Quality Monitoring Tracking and analysing performance metrics preparing reports and sharing insights to improve the claims processing function Compliance Ensuring all processes and handling of member provider data comply with regulations such as HIPAA Collaboration Working with operational teams to implement corrective measures and improve training programs Knowledge Management Developing and maintaining a thorough understanding of insurance policies products and the broader healthcare insurance industry Key Skills Qualifications Technical Skills Proficiency in claims adjudication systems quality management tools like the 7 QC tools and methodologies like Six Sigma Analytical Problem-Solving Skills Ability to analyze complex data identify discrepancies and develop effective solutions Knowledge of Regulations Strong understanding of industry regulations insurance policies and legal standards Communication Skills Effective communication to share insights and collaborate with different teams and stakeholders Attention to Detail Crucial for accurately verifying documentation and ensuring the completeness of claim information Interested candidates can call or whatsapp to (phone hidden) for interview process Job Types Full-time Permanent Pay 450 000 00 - 600 000 00 per year Advantages Health insurance Leave encashment Paid sick time Paid time off Provident Fund Education Bachelor s Required Experience QA-Claims 4 years Required Location Indore Madhya Pradesh Required Application Deadline 15 10 2025 Expected Start Date 13 10 2025

📌 Quality - Sme (Madhya Pradesh)
🏢 Star Secutech
📍 Madhya Pradesh