Transaction Quality Team Manager / Healthcare

Transaction Quality Team Manager (Healthcare) Position: Transaction Quality Team ManagerDepartment: Quality AssuranceLocation: Coimbatore, Tamil Nadu Mode: WFOReports to: Associate Director / Head of Quality Job Summary We are seeking an experienced and dedicated Transaction Quality Team Manager to oversee the quality assurance framework for our healthcare-specific back-office & contact center operations. This role is critical in ensuring the accuracy, compliance, and efficiency of transactional processes such as medical coding, claims processing, provider data management, and member eligibility. The ideal candidate will be a subject matter expert in healthcare BPO quality, with a proven track record of leading teams, developing robust quality monitoring systems, and driving continuous improvement in a highly regulated environment. You will be responsible for safeguarding the integrity of our work, ensuring adherence to HIPAA, and directly impacting client satisfaction and operational performance. Key Responsibilities • Quality Strategy & Framework: • Develop, implement, and maintain the overall quality assurance strategy for healthcare transactional teams. • Design and refine quality scorecards, audit forms, and evaluation criteria specific to healthcare processes (e.g., HCFA/UB04 forms, ICD-10, CPT codes, HCPCS). • Ensure the quality framework aligns with client-specific requirements and industry best practices (e.g., AHIMA, AAPC guidelines).• Team Leadership & Management: • Lead, mentor, and develop a team of Quality Analysts and Auditors. • Conduct regular performance reviews, provide constructive feedback, and create individual development plans. • Foster a culture of quality, accountability, and continuous learning within the team.• Monitoring & Analysis: • Oversee the execution of transaction monitoring (voice and non-voice) for 100% of key processes or through a statistically valid sampling methodology. • Perform deep-dive analysis of quality data to identify trends, root causes of errors, and systemic issues. • Generate and present comprehensive quality performance reports to senior management and clients, highlighting insights and actionable recommendations.• Compliance & Risk Management: • Serve as the primary point of contact for all quality-related compliance issues. • Ensure all transactions and processes strictly adhere to HIPAA privacy and security regulations. • Stay abreast of changes in healthcare regulations and payer policies, and proactively update quality standards accordingly.• Continuous Improvement & Calibration: • Partner with Operations, Training, and Client Management teams to bridge quality gaps and improve process efficiency. • Lead and participate in calibration sessions with operations leaders to ensure consistency and fairness in quality evaluations. • Drive initiatives to reduce error rates, improve turnaround time, and enhance the overall customer (member/provider) experience.• Client Engagement: • Act as the quality SME in client meetings and business reviews. • Effectively communicate quality performance, improvement plans, and value delivered. Qualifications and Experience • Required: • Bachelors degree in Business Administration, Healthcare Management, or a related field. • Minimum of 8-10 years of experience in a Quality Assurance role within a Healthcare BPO setting. • Minimum of 5-7 years in a direct people management/leadership role. • In-depth, hands-on experience with healthcare transactional processes: Medical Billing, Claims Adjudication, Medical Coding (ICD-10, CPT), Provider Data Management, or Member Enrollment. • Expert knowledge of HIPAA regulations and their application in a BPO environment. • Proven experience designing quality frameworks, scorecards, and reporting dashboards.• Preferred: • Relevant professional certifications (e.g., CPHQ - Certified Professional in Healthcare Quality, CPC - Certified Professional Coder, CHFP - Certified Healthcare Financial Professional). • Experience with Six Sigma (Green/Black Belt) or Lean methodologies will be an added advantage • Proficiency in using Quality Management software and MS Office Suite, particularly advanced Excel and PowerPoint. Key Competencies • Exceptional Leadership & People Management• Analytical & Problem-Solving Mindset• Excellent Communication & Interpersonal Skills• High Attention to Detail & Accuracy• Client-Focused & Results-Oriented• Ability to Thrive in a Fast-Paced, Deadlines-Driven Environment• Strong Ethical Standards and Integrity

Valid PAN Number - _____________________(Why PAN Required > Mandatory to Process Candidature & Find Duplicity in Internal PAN Validation Process and also to initiate a screening call.

Share your updated CV @

Sonali Chattopadhyay I Associate People Success