We are seeking a dedicated and detail-oriented
Quality Assurance Analyst to support and enhance the performance of our
call center operations within the
US healthcare domain . The QA Analyst will monitor and evaluate calls and customer interactions to ensure high-quality service delivery, compliance with healthcare regulations (HIPAA), and alignment with organizational standards. The ideal candidate will have experience in US healthcare customer service, strong analytical skills, and a passion for improving the member and provider experience
- Monitor inbound and outbound calls, chat, and email interactions for accuracy, professionalism, and compliance with policies and procedures.
- Evaluate agent performance based on pre-defined quality standards including customer service, technical accuracy, and adherence to scripts and regulations.
- Provide actionable feedback and coaching recommendations to supervisors and trainers to improve agent performance.
- Collaborate with call center leadership to develop and refine QA scorecards and quality metrics.
- Ensure compliance with HIPAA, CMS guidelines, and other regulatory standards.
- Identify trends, recurring issues, and training opportunities based on quality evaluations and customer feedback.
- Assist in the development and implementation of call center best practices and continuous improvement initiatives.
- Maintain detailed QA records and reports; present findings to management in a clear and actionable format.
- Participate in calibration sessions to ensure consistency in QA scoring across evaluators.
Support special audits, complaint investigations, and root cause analysis as needed
- Bachelor s degree or equivalent work experience in healthcare, business, or a related field.
- 2+ years of quality assurance or call monitoring experience in a US healthcare call center environment .
- Familiarity with healthcare terms, insurance processes, member eligibility, provider inquiries, and claims inquiries.
- Strong understanding of HIPAA compliance and healthcare privacy regulations.
- Experience with QA tools and call recording systems (e.g., NICE, Verint, Genesys, Five9, Calabrio).
- Excellent verbal and written communication skills.
- Detail-oriented with strong analytical and problem-solving skills.
Ability to work independently and collaboratively in a fast-paced environment