Intake Quality Assurance Specialist

About this job

As an Intake Quality Assurance Specialist at Cohere Health in Hyderabad, you will play a crucial role in implementing quality measurements, scoring, and performance improvement data to boost operational efficiency. Cohere Health operates a clinical intelligence platform and agentic AI-powered solutions that connect health plans' strategic goals and providers' needs, optimizing care quality, speed, and cost. In this role, you will use your subject-matter expertise to guide training and quality needs within Intake Operations. A normal day involves translating quality analysis findings into actionable insights, conducting structured coaching sessions, maintaining and creating SOPs and workflow guides, facilitating onboarding and upskilling, and partnering with cross-functional teams like Product, Clinical, and Client Services. You will also manage concurrent projects, address quality trends, and occasionally step into operational queues to support service levels during high-volume periods, all while embodying the company culture of partnership and ownership.

Responsibilities

• Translate QA findings into actionable insights and recommendations for operational leaders and cross-functional teams.
• Develop and conduct structured coaching sessions based on audit results to enhance accuracy and skill development.
• Create and maintain accurate SOPs, job aids, workflow guides, and readiness materials for new products.
• Facilitate onboarding and upskilling sessions applying adult learning principles and stakeholder feedback.
• Partner with Product, Clinical, Client Services, and Operations teams to validate workflow changes and manage compliance risks.
• Serve as a subject-matter expert advising frontline leaders on quality trends, training needs, and operational readiness.
• Step into operational queues during high-volume periods to maintain service levels and ensure operational continuity.

Requirements

• 5 to 7 years of experience in US Healthcare Payer Processes.
• Experience in US healthcare operations, medical billing, claims, or prior authorization.
• Minimum 3 years of experience in a Quality assurance role.
• Knowledge of HIPAA regulations and patient privacy practices.
• Strong attention to detail with verbal and written communication skills.
• Data collection, management, and analysis capabilities.
• Problem analysis, problem-solving, planning, and organizing skills.
• Comfort working in a Mac-based environment.

Good to have

• Proficiency with Google Workspace including pivot tables, charts, and dashboards.
• Experience identifying performance trends and root causes using data.
• Experience using quality management systems and conducting structured QA audits.
• Experience facilitating coaching sessions and delivering constructive feedback.
• Understanding of Adult Learning Theory and Training.

Who should apply

This role is ideal for professionals with substantial experience in US healthcare payer processes and quality assurance. Candidates should possess a strong background in healthcare operations, medical billing, claims, or prior authorization, along with a solid understanding of HIPAA regulations. It suits individuals with strong data analysis capabilities, problem-solving skills, and the ability to manage multiple projects independently. The posting does not state that freshers can apply, as specific mid-to-senior experience requirements must be met.

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