Quality Auditor (QA)

MDI NetworX LLC.; Pune District; On-site; INR 600,000 - 1,000,000; Full time

Job summary

MDI NetworX LLC. seeks an experienced auditor with healthcare payer knowledge to perform claim audits using HRP or Facets to ensure accuracy and compliance. The role involves error analysis, RCA, and CAPA implementation to support continuous improvement.

You will handle rebuttals, feedback, and coaching to drive performance across teams. You will prepare and maintain audit reports, dashboards, and error logs, and communicate findings clearly to stakeholders while ensuring SOPs and client

Qualifications

• Experience in payer industry audit processes and healthcare quality standards.
• Ability to conduct error analysis, root cause analysis (RCA) and CAPA.
• Experience handling rebuttals, feedback and coaching to improve performance.
• Proficiency in preparing audit reports, dashboards and error logs.
• Effective communication of audit findings to stakeholders and SOP adherence.

Responsibilities

• Perform claim audits in HRP or Facets applications to ensure accuracy and compliance.
• Conduct error analysis, RCA, and CAPA implementation to support accuracy improvements.
• Handle rebuttals, feedback, and coaching to drive performance improvement.
• Prepare and maintain audit reports, dashboards, and error logs.
• Communicate audit findings effectively and collaborate with stakeholders for process improvements.
• Ensure adherence to SOPs, client requirements, and quality standards.

Tools

HRP

Facets

Audit dashboards

Error analysis

RCA

CAPA implementation

Job description

• Good Healthcare knowledge -Payer industry
• Preferred to perform claim audits in HRP or Facets applications to ensure accuracy and compliance.
• Able to do error analysis, RCA, and CAPA implementation to support accuracy improvement
• Handle rebuttals, feedback, and coaching to drive performance improvement.
• Prepare and maintain audit reports, dashboards, and error logs.
• Communicate audit findings effectively and collaborate with stakeholders for process improvements.
• Ensure adherence to SOPs, client requirements, and quality standards