Archana Santhosh

Senior Quality Compliance Analyst with 4+ years of experience in U.S. healthcare processes, specializing in compliance auditing, grievance handling, and process improvement. Proven ability to identify quality gaps, perform root cause analysis, and implement solutions that enhance operational efficiency and regulatory adherence. Skilled in data analysis using Microsoft Excel and experienced in training teams to improve service quality and compliance standards.

Senior Quality Compliance Analyst at EXL (2022-10 – 2024-11)

• Analysed healthcare compliance processes to ensure adherence to U.S. regulatory standards
• Conducted quality audits and identified process gaps, improving overall compliance performance
• Performed root cause analysis on quality issues and implemented corrective actions
• Trained and mentored team members on compliance requirements and quality standards
• Monitored employee performance and delivered structured feedback to improve accuracy and productivity
• Prepared detailed reports by analysing quality data and identifying trends
• Collaborated with cross-functional teams to drive process improvements
• Reported compliance risks and unethical practices to maintain organizational integrity
• Maintained documentation related to audits, inspections, and quality assurance activities

Compliance & Grievance Analyst at EXL (2020-02 – 2022-09)

• Managed grievance and appeals processes for U.S. healthcare insurance clients
• Analysed claims and determined appropriate resolutions based on regulatory guidelines
• Coordinated with medical and nursing teams for detailed case reviews
• Ensured timely routing and resolution of claims to meet SLA requirements
• Liaised with legal, appeals, and international teams to resolve complex cases
• Handled both complex and non-complex cases with accuracy and efficiency

Bachelor of Technology in Electronics & Communication Engineering – Musaliar College of Engineering and Technology (2014 – 2018)