TL Quality

Job Title : Quality Team Lead (QTL) – US Healthcare Claims

Experience : 5+ years in Claims Adjudication, 3+ years in Quality Assurance

Job Description :

We are seeking a skilled Quality Team Lead (QTL) with strong expertise in US Healthcare claims adjudication and Quality Assurance practices . The role involves leading quality audits, ensuring compliance, identifying process gaps, and driving performance improvements through RCA, CAPA, and Six Sigma methodologies. The QTL will guide Quality Analysts, collaborate with operations, and ensure delivery of high-quality outcomes.

Key Responsibilities :

• Lead and monitor quality audits in claims adjudication.
• Ensure compliance with HIPAA, CMS, and client requirements.
• Apply 7 QC tools, RCA, CAPA, and Six Sigma to reduce errors and improve accuracy.
• Provide coaching, feedback, and training to QA teams.
• Collaborate with stakeholders to implement process improvements.

Mandatory Skills :

Skills Required

Claims Processing, Quality Assurance