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Quality Analyst

2 - 7 years

4 - 9 Lacs

Posted:22 hours ago| Platform: Naukri logo

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Job Type

Full Time

Job Description

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

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