Ka Compliance assurance specialist Jobs – 219 Open Jobs Today

Healthcare Support Representative
XO Health Inc. —Bengaluru, Karnataka
- ₹5,00,000 - ₹15,00,000 a year
- Rotational shift
- Remote
- Spanish
- English
- Research
- Health insurance
Quick apply
Regulatory Affairs Specialist
Natus Sensory —Bengaluru, Karnataka
- Full-time
- Remote
- English
- Continuous improvement
- Health insurance
- Paid time off
13d
Specialist - PMO
Prudential plc —Bengaluru, Karnataka
- Full-time
- Microsoft Powerpoint
- Project management
- Agile
Change Specialist
ALSTOM —Bengaluru, Karnataka
- Full-time
- Computer Science
- Supervising experience
- Bachelor's degree
Associate Technical Director
AtkinsRéalis —Bengaluru, Karnataka
- Full-time
- Remote
- B.Sc
- Engineering
- Bachelor's degree
- Health insurance
Junior Computer System Validation (CSV) Specialist
Eiffel Life Sciences —Bangalore City, Bengaluru, Karnataka
- From ₹50,000 a month
- Email
- Computer Science
- Bachelor's degree
- In-person
- Flexible schedule
- Food provided
Quick apply
Quality Specialist (QMS, Documentation)
Merck KGaA —Bengaluru, Karnataka
- Master's degree
- Communication skills
Manager, Client Experience
Pebl —Bengaluru, Karnataka
- ₹15,00,000 - ₹20,00,000 a year
- Full-time
- Hybrid work
- Analysis skills
- Continuous improvement
- Human resources
Quick apply
2d
Compliance Assurance Specialist
NES Internal —Bengaluru, Karnataka
- Hybrid work
- Microsoft Excel
- Microsoft Outlook
- English
- Health insurance
- Paid time off
Compliance Auditor
NES Internal —Bengaluru, Karnataka
- Microsoft Powerpoint
- Microsoft Excel
- Microsoft Outlook
- Health insurance
- Paid time off
BIM - Assistant Technical Manager - ( Highway / Roads )
AtkinsRéalis —Bengaluru, Karnataka
- Full-time
- Remote
- AutoCAD
- Civil engineering
- CAD
- Health insurance
Lead Specialist - Project Quality
Autoliv India —Chikkaballapura District, Karnataka
- ₹20,00,000 a year
- Engineering
- ERP systems
- English
AML QA Specialist with Chinese, Account Compliance Quality
ADCI - Karnataka - A66 —Bengaluru, Karnataka
- Full-time
- Spanish
- Microsoft Excel
- Master's degree
BIM Coordinator / Information Manager
AtkinsRéalis —Bengaluru, Karnataka
- Full-time
- Remote
- English
- Bachelor's degree
- Construction experience
- Health insurance
Risk and Compliance Specialist
Accenture —Bengaluru, Karnataka
- Full-time
- Master's degree
- Bachelor's degree
- Business Administration
Senior M365 Specialist
Resillion —Bengaluru, Karnataka
- Full-time
- Hybrid work
- Azure
- Scripting
- SharePoint
Quick apply
Associate - Telecoms
WSP —Bengaluru, Karnataka
- Hybrid work
- Microsoft Powerpoint
- Microsoft Word
- AutoCAD
12d
Associate Position Management Specialist
Cargill —Bengaluru, Karnataka
- English
- Bachelor's degree
- Human resources
Computer Vision Data Annotation & Person Detection Specialist
AMETEK, Inc. —Bengaluru, Karnataka
- Computer Science
- Project management
- Bachelor's degree
4d
Customer Experience Team Lead
IG Group —Bengaluru, Karnataka
- Full-time
- Customer service
- English
- Finance
6d

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Healthcare Support Representative

XO Health Inc. -
Bengaluru, Karnataka

Quick apply

Job details

₹5,00,000 - ₹15,00,000 a year

Benefits

Health insurance

Qualifications

Spanish
EDI
English
Research
Microsoft Office
Analysis skills
Quality assurance
Bachelor's degree
Medical billing
ServiceNow
Billing
Communication skills

Full job description

XO Health believes healthcare is fixable. Become part of the community changing the face of the industry.

XO Health is the first health plan designed by and for self-insured employers that delivers a more unified health experience for everyone – from those who receive care, to those who deliver it, to those who pay for it.

We are growing a multi-disciplinary team of diverse and digitally empowered employees ready to rebuild trust in healthcare through comprehensive and unified transformation.

XO Health Healthcare Support Representative

About the job

XO Health believes healthcare is fixable. Become a part of the community changing the face of the industry. XO Health is the first health plan designed by and for self-insured employers that delivers a more unified health experience for everyone-from those who received care, to those who deliver it, to those who pay for it. We are growing a multi-disciplinary team of diverse and digitally empowered employees ready to rebuild trust in healthcare through comprehensive and unified transformation.

About the Role:

Remote- USA, India -Virtual Contact Center and Claims Operations

The Operations Specialist is a key member of XO Health's operations team, supporting both member/provider service (Advocacy) and claims processing and resolution (Claims Operations).

This blended role serves as a primary point of contact for members and providers through an omni-channel environment (phone, email, chat), while also functioning as a claim's operations expert responsible for accurate claim processing, research, adjudication, adjustments, and issue resolution.

This position requires a strong service-first mindset, high attention to detail, and the ability to move seamlessly between real-time support and behind-the-scenes operational work. The Operations Specialist partners cross-functionally with internal teams and third-party vendors to ensure members and providers receive timely, compliant, and high-quality support across the operations.

Key Responsibilities:

Member & Provider Advocacy

Handle inbound and outbound member and provider inquiries via phone, email, and chat with professionalism and empathy.
Initiative member outreach to provide information and assistance regarding benefits.
Provide accurate information regarding benefits, eligibility, and coverage; claims status and adjudication details; prior authorization requirements and submissions; billing and reimbursement policy questions; and provider portal navigation and support.
Resolve inquiries, complaints, grievances, and escalations promptly while ensuring complete documentation and proper routing when needed.
Conduct follow-up outreach to ensure resolution, satisfaction, and continuity of care or claim outcomes.
Build trust with members and providers through early, frequent, and personalized engagement.

Claims Processing, Adjudication & Resolution

Process, research, and adjudicate institutional and professional medical claims (including behavioral health), ensuring accuracy, timeliness, and compliance.
Verify eligibility, coverage, and medical necessity under policy guidelines using established systems and workflows.
Investigate and resolve claim denials, appeals, discrepancies, overpayments, and billing errors and payment issues.
Conduct overpayment reviews, coordinate recovery actions, and correct claim financial histories as required.
Support high-cost claim and claimant processes as needed.

Provider Data, Outreach & Operational Support

Perform provider outreach as necessary to support claims resolution, documentation needs, and payment accuracy.
Collect W-9s and maintain accurate provider information within XO systems to support claims processing, reporting, directory publication, and data transfers.

Cross-Functional Collaboration & Continuous Improvement

Collaborate with Business Operations, Network Performance, Product, and Experience teams to resolve complex cases and improve service delivery.
Coordinate with third-party claims vendors to maintain accuracy, compliance, and service excellence.
Identify recurring issues, system gaps, or process inefficiencies and provide feedback to leadership.
Perform quality assurance reviews to ensure claims financial and procedural accuracy.
Document procedures, workflows, and operational guidance as needed.

Performance & Compliance Expectations

Meet performance goals in areas such as efficiency and productivity, quality and accuracy, customer satisfaction, compliance, follow-up completion, and attendance.
Maintain confidentiality and compliance with HIPAA, ERISA, and XO Health policies.

Experience Required:

The qualified candidate will have:

3–5 years of experience in a healthcare payer, TPA, or health insurance environment, with a blend of contact center/member-provider support and/or medical claims processing/adjudication/claims operations.
Strong knowledge of health insurance concepts, benefits and eligibility, medical terminology, and claims lifecycle management.
Strong English language verbal and written communication skills, with an empathetic, solution-oriented approach.
High attention to detail, sound judgment, and strong analytical problem-solving skills.
Ability to multitask in a fast-paced, digital-first environment while maintaining accuracy and professionalism.
Proficiency in Microsoft Office Suite and customer service and/or claims processing systems.

Preferred Skills:

Associate or bachelor's degree in healthcare administration, business, or a related field.
Experience with consolidated billing/payment platforms and/or alternative payment models (bundled payments).
Familiarity with Availity Essentials, payer portals, and EDI standards.
Familiarity with Genesys, Service Now, and other CRM tools
Familiarity with Facility, DME, Behavioral Health, and Stop-Loss claim types.
Experience in payment integrity, provider relations, or medical billing.
Spanish language proficiency (written and verbal) is a plus.

Additional Details:

Must be able to support USA contact center hours.
Must be able to participate in a rotating on-call schedule for urgent member and provider support needs.

XO Health is an equal opportunity employer committed to diversity and inclusion in the workplace. All qualified applicants will receive consideration for employment without regard to sex (including pregnancy, childbirth or related medical conditions), race, color, age, national origin, religion, disability, genetic information, marital status, sexual orientation, gender identity, gender reassignment, citizenship, immigration status, protected veteran status, or any other basis prohibited under applicable federal, state or local law. XO Health promotes a drug-free workplace.

Quick apply

Refine Your Search

compliance assurance specialist jobs in ka

Healthcare Support Representative

Regulatory Affairs Specialist

Specialist - PMO

Change Specialist

Associate Technical Director

Junior Computer System Validation (CSV) Specialist

Quality Specialist (QMS, Documentation)

Manager, Client Experience

Compliance Assurance Specialist

Compliance Auditor

BIM - Assistant Technical Manager - ( Highway / Roads )

Lead Specialist - Project Quality

AML QA Specialist with Chinese, Account Compliance Quality

BIM Coordinator / Information Manager

Risk and Compliance Specialist

Senior M365 Specialist

Associate - Telecoms

Associate Position Management Specialist

Computer Vision Data Annotation & Person Detection Specialist

Customer Experience Team Lead

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