Bengaluru Karnataka Quality analyst medical Jobs – 288 Open Jobs Today

SPE-Claims HC
Cognizant —Bengaluru, Karnataka
- Full-time
- Remote
- Nursing
- B.Sc
- Analysis skills
- Health insurance
- Work from home
Quality Analyst
GetixHealth India —Bengaluru Urban District, Karnataka
- Analysis skills
- Communication skills
- Commuter assistance
Quick apply
Quality Control Analyst - Medical Coding- EM/Surgery
Rapid Claims —Bangalore City, Bengaluru, Karnataka
- Full-time
- Hybrid work
- Analysis skills
- In-person
- AI
Quick apply
14d
Support Operations Analyst
Riverbed Technology, Inc. —Bengaluru, Karnataka
- Microsoft Excel
- Customer service
- Salesforce
Quality Control Analyst -Auditor– Medical Coding
Rapid Claims —Bangalore City, Bengaluru, Karnataka
- Full-time
- Hybrid work
- Analysis skills
- Quality control
- In-person
Quick apply
Senior Analyst — US Medical Analytics & Insights
Takeda Pharmaceutical —Bengaluru, Karnataka
- Full-time
- English
- SQL
- Analysis skills
- Health insurance
- Cell phone reimbursement
7d
Global Banking & Markets Operations-Transaction Banking-Analyst-Bengaluru
Goldman Sachs —Bengaluru, Karnataka
- Microsoft Excel
- Bachelor's degree
- Communication skills
- Health insurance
Analyst Supplier Quality
Fresenius Medical Care —Bengaluru, Karnataka
- Microsoft Excel
- B.Sc
- Engineering
Asset & Wealth Management - PWM WSS- Analyst- Bengaluru
Goldman Sachs —Bengaluru, Karnataka
- Salesforce
- Finance
- Master's degree
- Health insurance
Data Analyst
ServiceChannel —Bengaluru, Karnataka
- Machine learning
- Communication skills
- Analytics
- Health insurance
- Life insurance
Real-World Evidence Analyst
Mango Sciences —Bengaluru, Karnataka
- Microsoft Powerpoint
- Microsoft Word
- Microsoft Excel
Senior Analyst - Life Sciences
Tracxn Technologies —Bengaluru, Karnataka
- Full-time
- Research
- Master's degree
- MBA
Asset and Wealth Management- Equity Structuring -Analyst- Bengaluru
Goldman Sachs —Bengaluru, Karnataka
- Microsoft Powerpoint
- Microsoft Excel
- Bachelor's degree
- Health insurance
Business Process Analyst
Caterpillar —Bengaluru, Karnataka
- Full-time
- Databases
- Software development
11d
Getix Job Openings
GetixHealth India —Bengaluru Urban District, Karnataka
- Night shift
Quick apply
Applications Support Analyst I
Labcorp —Bengaluru, Karnataka
- Full-time
- Hybrid work
- Azure
- Oracle
- Computer Science
Global Banking & Markets Operations - Private Lending Operations - Analyst-Bengaluru
Goldman Sachs —Bengaluru, Karnataka
- Microsoft Powerpoint
- Microsoft Word
- Microsoft Excel
- Health insurance
11d
Data Analyst, Operational Intelligence
Quickbase —Bengaluru, Karnataka
- Full-time
- Hybrid work
- Sales
- Salesforce
- SQL
- Health insurance
- Cell phone reimbursement
12d
Imaging Analyst
Nference —Bengaluru, Karnataka
- Hybrid work
- Research
- Master's degree
- Bachelor's degree
- Health insurance
Quick apply
Senior Regulatory Analyst
Clinisys —Bengaluru, Karnataka
- Hybrid work
- Master's degree
- Databases
- Analysis skills
- Health insurance
- Paid time off
6d

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SPE-Claims HC

Cognizant -
Bengaluru, Karnataka

Apply Now

Job details

Full-time

Benefits

Health insurance
Work from home

Qualifications

Nursing
B.Sc
Clinical experience
Analysis skills
Bachelor's degree

Full job description

Job Summary
This role supports health care claims operations by configuring and validating claim processing on Xcelys Claims Medical and QNXT Claims Medical platforms ensuring accurate adjudication for medical claims. The specialist uses strong domain knowledge in claims and medical benefits to improve cycle time reduce errors and support a high quality member and provider experience while working remotely during day shifts.

Responsibilities
Analyze health care claims on Xcelys Claims Medical and QNXT Claims Medical systems to ensure accurate benefit application and financially correct outcomes that support timely payments and customer satisfaction.
Review claim adjudication rules and configurations for medical benefits to maintain alignment with product policies regulatory requirements and operational guidelines while minimizing rework and claim reversals.
Execute end to end testing of claims adjudication scenarios in Xcelys and QNXT environments to validate pricing logic accumulators and edits before production deployment and reduce downstream defects.
Investigate claim exceptions denials and pended items by tracing benefit setup provider data and member eligibility to identify root causes and propose sustainable corrective actions.
Collaborate with business analysts and operations teams to translate claims business requirements into clear system changes for Xcelys and QNXT that enhance processing efficiency and quality.
Perform impact analysis for configuration updates on related claim flows including coordination of benefits prior authorization and referrals to prevent unintended disruptions.
Document standard operating procedures and reference guides for recurring claims scenarios so that operations teams can resolve issues consistently and accurately.
Monitor daily claims production reports to identify processing trends error patterns and aged inventories and then recommend targeted improvements for throughput and accuracy.
Support internal quality reviews by providing evidence of claim calculations rule interpretations and configuration decisions that demonstrate compliance with audit standards.
Respond to queries from cross functional stakeholders regarding claim outcomes by explaining configuration logic benefit interpretation and applicable business rules in an accessible manner.
Assist in continuous improvement initiatives focused on automation and simplification of claims adjudication steps which help lower operational cost and enhance member outcomes.
Coordinate with technology partners for defect triage and resolution where system behavior differs from documented design and ensure that validated fixes are deployed and tracked.
Maintain current knowledge of health care claims practices codes and payer guidelines so that configuration and adjudication decisions remain aligned with industry expectations and organizational policies.

Qualifications
Apply practical experience in medical claims adjudication to interpret complex benefit structures cost sharing rules and coverage limitations in a consistent and reliable manner.
Use hands on expertise with Xcelys Claims Medical to configure validate and troubleshoot benefit rules edits and accumulators for a wide range of medical claim types.
Leverage working knowledge of QNXT Claims Medical including claim workflows plan build and pricing configurations to support stable production operations.
Demonstrate strong domain understanding of claims life cycle encompassing intake adjudication adjustments recoveries and member and provider impacts.
Communicate clearly in a remote work from home setting using collaboration tools to align with distributed teams during standard day shifts.
Exhibit analytical and problem solving skills when interpreting data reconciling claim discrepancies and recommending targeted system or process changes.
Show adaptability by learning new payer products regulatory updates and platform enhancements that influence medical claims adjudication and configuration decisions.

Certifications Required
BSc Nursing with 2-3 years of clinical experience .

Apply Now

Refine Your Search

quality analyst medical jobs in bengaluru karnataka

SPE-Claims HC

Quality Analyst

Quality Control Analyst - Medical Coding- EM/Surgery

Support Operations Analyst

Quality Control Analyst -Auditor– Medical Coding

Senior Analyst — US Medical Analytics & Insights

Global Banking & Markets Operations-Transaction Banking-Analyst-Bengaluru

Analyst Supplier Quality

Asset & Wealth Management - PWM WSS- Analyst- Bengaluru

Data Analyst

Real-World Evidence Analyst

Senior Analyst - Life Sciences

Asset and Wealth Management- Equity Structuring -Analyst- Bengaluru

Business Process Analyst

Getix Job Openings

Applications Support Analyst I

Global Banking & Markets Operations - Private Lending Operations - Analyst-Bengaluru

Data Analyst, Operational Intelligence

Imaging Analyst

Senior Regulatory Analyst

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