Health Claims - Process & Quality Improvement

Job Title : Quality and Process Manager – Health Claims Operations

Location : Bangalore

Department : Health Claims Operations

Reports To : Head of Health Claims

Employment Type : Full-Time

Job Summary

We are seeking a highly analytical and process-driven Quality and Process Manager to lead quality assurance and process improvement initiatives within our Health Claims Operations team. This role is critical in ensuring claims are processed accurately, efficiently, and in compliance with regulatory standards, while driving continuous improvement across workflows and systems using Lean Six Sigma methodologies.

Key Responsibilities

Quality Assurance

• Develop and implement quality control frameworks for health claims processing.
• Monitor and audit claims to ensure accuracy, compliance, and timeliness.
• Identify root causes of errors and lead corrective action plans.
• Collaborate with training teams to address knowledge gaps and improve performance.

Process Management

Compliance & Risk

Stakeholder Collaboration

Key Performance Indicators (KPIs)

Qualifications & Skills

Education & Certifications

Skills

Preferred

Skills Required

pareto analysis, Power Bi, sipoc, Excel, Control Charts, Lean Six Sigma