Quality Review and Audit Senior Representative
YOUR JOB
As a Quality Review and Audit Senior Representative , you play a key role in safeguarding operational excellence across service delivery teams. You will be responsible for conducting quality audits, reviewing case accuracy, identifying process gaps, and ensuring adherence to internal procedures, regulatory guidelines, and customer commitments.
You will provide actionable feedback to team leaders and staff, support continuous improvement, and contribute to building a culture of quality, compliance, and consistency across Operations.
This role acts as a bridge between frontline teams, supervisors, and quality leaders by bringing insight, evidence-based recommendations, and root‑cause analysis into daily operations.
KEY RESPONSIBILITIES
Quality Review & Audit Execution
Conduct routine and targeted audits across operational workstreams (e.g., Claims, Eligibility, Admin, Customer Service, Client Support).
Assess accuracy, completeness, compliance, and alignment to SOPs and regulatory requirements.
Review system entries, documentation,



case handling, and communication quality.
Ensure audit scoring is objective, consistent, and aligned with the quality framework.
Insights, Feedback & Coaching Support
Provide explicit, constructive audit feedback to team members and supervisors.
Highlight high‑risk errors and recurring themes that require escalation.
Support team leaders in delivering quality coaching sessions.
Maintain accurate audit logs and records for reporting & governance.
Risk & Compliance Support
Identify potential compliance gaps, regulatory breaches, or quality risks.
Escalate critical findings promptly to supervisors and Quality leads.
Support adherence to audit requirements for internal control, risk management, and governance processes.
Continuous Improvement
Recommend improvements to processes, documentation, and training materials.
Assist in revising SOPs or workflows when audit trends indicate the need for

📌 Quality Review and Audit Senior Representative (Bengaluru)
🏢 Cigna Healthcare
📍 Bengaluru