Quality Analyst - Payment Integrity

Job Description:

Perform second-level QA on claims audited by the payment integrity audit team
Validate audit findings, rationale, and payment accuracy
Ensure audits are compliant, complete, and client-ready
Provide feedback & coaching to auditors and maintain QA reports
Drive quality improvements and error reduction

Who Should Apply:

1+ years in Healthcare QA / Quality Analyst role , acting QA
Strong background in Payment Integrity, Payment Accuracy, Claims Audit, Healthcare Audit
Understanding of US Healthcare Payer side - Claims adjudication, Overpayment / Underpayment concepts, Coordination of Benefits
Experience in related fields also welcome: Claims Review, Payment Validation, Healthcare Operations QA, RCM QA, Utilization Review QA, Provider / Payer Audit, Fraud Waste & Abuse , Healthcare Compliance Audit, Healthcare Operations Quality

Interested candidates can apply on Naukri or share their updated resumes on [email removed]