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Quality Analyst (POS00373)

5.00 to 7.00 Years   Mumbai City   06 Jun, 2023
acko
Job LocationMumbai City
EducationNot Mentioned
SalaryNot Disclosed
IndustryIndustrial Design
Functional AreaGeneral / Other Software
EmploymentTypeFull-time

Job Description

    Competencies and Skills Required: Post-graduate/Graduate in any faculty from a recognized University/Institution. Good command of written and spoken English & Hindi/Other regional languages. Must be able to manage oneself, lead by example, be proactive & work with little provision. The Certified Internal Auditor certification & similar credentials are preferred. 5 to 7 years of work experience in Health insurance claims internal audit environment, both closed file review & open file review. Excellent audit report-writing skills backed with metrics, tolerances, deviations, & samples that are time-tested. The thoroughness of the insurance regulatory requirements. Proficient in advanced excel, word, powerpoint & report drafting using measurement metrics. Rolls & Responsibilities : Insurance & Regulatory Awareness: Protects assets for a company or organisation, ensures compliance with internal procedures, and maintains knowledge of industry regulators. Internal Audit Management: Planning (develops & manages) & execution of the claims internal QA & audit function by liaisoning with concerned stakeholders. To develop audit guidelines & parameters based on standard operating procedures, organization & regulatory guidelines, internal checks & controls, BI & governance, risk controls & other key objectives & apply a thorough understanding of governance, risk, and control appropriate to the organization to ensure standarisation, consistency, efficiency, productivity & attain high industry benchmarks. Business Acumen: Maintains expertise in the business environment, industry practices, and specific organizational factors of quality assurance & claims audit end-to-end i.e., Closed File Review (CFR) & Open File Review (OFR). Improvement & Innovation: Embraces change and drives improvement and innovation, evaluates internal control and makes recommendations on how to improve, handhold, support, follow-up to implement improvements & test post that for action adherence. Proactive: Makes recommendations proactively for the best ways for a company to avoid risk, fraud & adhere to the processes, & controls keeping in mind organizational expectations, business models, claims philosophy & key control measurements. ,

Keyskills :
qualitycustomer relationstest casescalibrationauditingstandard operating proceduresinternal auditadvanced excelspoken englishembraces changehealth insuranceinsurance claimsinternal controlquality assuranceinsurance regulatoryregulatory guid

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