Must be a certified nursing professional (GNM/B.Sc Nursing/MBBS/BAMS/BHMS) with a valid Indian medical/nursing degree - Mandatory
1-2 years of experience in a supervisory or quality role in a US healthcare BPO/KPO process (e.g., claims, RCM, utilization review) - Preferred
Strong understanding of US healthcare workflows such as claims adjudication, prior authorization, clinical documentation, or medical coding - Preferred
Excellent medical judgment and clinical knowledge to support case reviews, escalations, and documentation validations - Mandatory
Good communication skills to liaise between operations, QA teams, and US-based clients or providers
Experience in process audits, compliance checks, and training new hires on clinical guidelines
Familiar with HIPAA regulations, EMR/EHR systems, and US insurance terminologies and ICD/CPT codes - - Preferred
Job Type: Full-time
Pay: ₹30,000.00 - ₹40,000.00 per month
Work Location: In person
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