Quality Manager in Hyderabad

Opportunity Overview: We are seeking a versatile and highly skilled Lead Claims Auditor to join our dynamic Payment Integrity team. This critical role involves conducting comprehensive professional and facility coding reviews—encompassing both outpatient/professional and inpatient claims—to ensure the accuracy of code assignment, DRG/reimbursement, and to maximize overpayment identification. If you possess a CPC and/or CCS credential, expert knowledge of CPT, HCPCS, and ICD-10-CM/PCS coding guidelines, and a passion for deep analytical auditing, you will be instrumental in supporting our commitment to accurate reimbursement solutions. This opportunity requires a self-motivated individual who thrives on precision, compliance, and continuous learning in a high-growth environment What you’ll do: Conduct comprehensive coding reviews to ensure accuracy in code assignment and reimbursement. Conduct comprehensive outpatient and professional coding reviews to ensure accuracy in code assignment and reimbursement. Apply expert knowledge of coding guidelines and utilize industry-leading tools to maximize overpayment identifications. Conduct ambulatory surgery center, emergency room, observation and infusion coding reviews. Apply expert knowledge of coding guidelines and utilize industry-leading tools to maximize overpayment identifications. Craft clear, concise, and well-supported audit findings, backed by AHA Coding Clinic Guidelines and ICD-10-CM/PCS regulations. Utilize advanced DRG encoder tools (such as 3M, Webstrat) to drive efficiency and accuracy in audits. Meet or exceed company quality and productivity standards, including strong uphold rates for appeals. Stay ahead of industry trends, coding updates, and compliance regulations to maintain expert-level knowledge. Adhere to HIPAA and company policies and procedures to ensure data security and regulatory compliance. Maintain and apply superior knowledge of changes and updates to coding guidelines, reimbursement trends,

Opportunity Overview: We are seeking a versatile and highly skilled Claims Auditor to join our dynamic Payment Integrity team. This critical role involves conducting comprehensive professional and facility coding reviews—encompassing both outpatient/professional and inpatient claims—to ensure the accuracy of code assignment, DRG/reimbursement, and to maximize overpayment identification. If you possess a CPC and/or CCS credential, expert knowledge of CPT, HCPCS, and ICD-10-CM/PCS coding guidelines, and a passion for deep analytical auditing, you will be instrumental in supporting our commitment to accurate reimbursement solutions. This opportunity requires a self-motivated individual who thrives on precision, compliance, and continuous learning in a high-growth environment What you’ll do: Conduct comprehensive coding reviews to ensure accuracy in code assignment and reimbursement. Conduct comprehensive outpatient and professional coding reviews to ensure accuracy in code assignment and reimbursement. Apply expert knowledge of coding guidelines and utilize industry-leading tools to maximize overpayment identifications. Conduct ambulatory surgery center, emergency room, observation and infusion coding reviews. Apply expert knowledge of coding guidelines and utilize industry-leading tools to maximize overpayment identifications. Craft clear, concise, and well-supported audit findings, backed by AHA Coding Clinic Guidelines and ICD-10-CM/PCS regulations. Utilize advanced DRG encoder tools (such as 3M, Webstrat) to drive efficiency and accuracy in audits. Meet or exceed company quality and productivity standards, including strong uphold rates for appeals. Stay ahead of industry trends, coding updates, and compliance regulations to maintain expert-level knowledge. Adhere to HIPAA and company policies and procedures to ensure data security and regulatory compliance. Maintain and apply superior knowledge of changes and updates to coding guidelines, reimbursement trends, and

Ready to do the most impactful work of your career? At Coinbase , we are uncompromising on our mission to increase economic freedom. The bar is high, the environment is intense, and we like it that way. This isn't a place for complacency, it’s a place to be pushed past your perceived limits. If you're ready to build the future of finance alongside people who refuse to settle for "good enough," you belong here. Coinbase is a remote-first, but not remote-only company. Expect to get together quarterly for intense in-person working sessions called “surges.” learn more about working at Coinbase . As a Screening Compliance Analyst II on the CX Compliance team within Customer Experience, you'll conduct end-to-end screenings of customers, individuals, and entities to protect Coinbase from financial crime risk. This team ensures our global operations comply with AML, sanctions, and KYC regulatory requirements while delivering consistently high-quality outcomes. You'll analyze screening results independently, escalate potential compliance risks to the Financial Crime Risk Service (FCCS) team, and contribute to process improvements that strengthen the screening function's accuracy and scalability. What you'll do: Own end-to-end screening processes to identify potential risks associated with customers, individuals, and entities using screening tools and databases, ensuring timely and accurate disposition of alerts. Analyze transaction activity and KYC information, conduct due diligence research, and recommend whether activity warrants escalation to the Financial Crime Risk Service (FCCS) team. Maintain detailed documentation of screening decisions to demonstrate compliance with regulations, internal policies, and audit requirements. Incorporate feedback from the Quality Assurance team and participate in calibration sessions to improve screening accuracy and consistency across the function. Identify gaps in screening procedures and contribute recommendations for proc