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Specialist, Quality Assurance

4 months ago

Diamond Bar, United States Call the Car Full time
Job DescriptionJob DescriptionJob Description

We are currently expanding our team and looking for a Quality Assurance Specialist to join us. If you're passionate about healthcare and making a difference in people's lives, this is the job for you

BASIC JOB PURPOSE: Quality Assurance Specialist is responsible for investigating and documenting complaints/grievances received, both internal and external, and to analyze and report trending of grievance categories.

RESPONSIBILITES/DUTIES BUT NOT LIMITED TO:

  • Receive, record, and respond to complaints/grievances in a friendly and professional matter.
  • As part of an investigation, completes outreach to external parties (ex. providers, facilities, members, or other parties) involved in the grievance.
  • Evaluates grievance details and proposes recommendation while remaining in compliance with Call the Car policies.
  • Maintains knowledge of Call the Car policies in accordance with applicable regulatory requirements and external laws.
  • Acts as a liaison between Call the Car departments to coordinate information relevant to a complaint or grievance.
  • Completes work within strict deadlines and escalates perceived delays to leadership.
  • Writes resolution letters and corresponds with members and providers by phone and in writing.
  • Ensure timely communication, follow up, review, and resolution of concerns, complaints, grievances, incidents, injuries, and accidents reported.
  • Manages group email boxes, logs new cases received by email, and archives completed emails.
  • Ensures all departmental goals (including, but not limited to turnaround, production expectations, and quality metrics) are met.
  • Collaborates with Quality Management on Quality Assurance workplan to meet requirements.
  • Identifies trends and root cause of issues; proposes solutions or escalates ongoing issues to the Lead Quality Assurance Specialist.
  • Report needs for internal corrective action to Lead Quality Assurance Specialist.
  • Any other duties as assigned by management.

PREFERRED QUALIFICATIONS:

  • Ability to adapt to a changing environment and handle multiple priorities.
  • Ability to work independently or with a team.
  • Excellent problem solving, organization, multi-tasking, and time management skills.

REQUIREMENTS:

  • 1-2 year(s) of relevant working experience in healthcare setting preferred.
  • 1–2-year(s) call center experience in a customer service setting preferred.
  • Minimum high school diploma or GED required.
  • Proficiency with Microsoft Office (Word, Excel, PowerPoint, Outlook) required.
  • Excellent written and verbal communication skills required.
  • Must pass a Criminal Background Screening and a Drug Screen.
  • Must pass government exclusion list at time of hire and monthly thereafter.

Work Location: Diamond Bar, CA. This is an onsite position.

Working Shifts: Monday – Friday, 8-hour shift between the hours of 6:00am - 5:30pm

COVID Vaccine Requirement: To ensure a safe working environment for our employees, members, and community, Call the Car requires all employees to be fully vaccinated as a term and condition of employment. Proof of COVID-19 vaccination will be required upon date of hire.

TYPICAL WORKING CONDITIONS: Office environment. May require working under stress and tight deadlines. The position requires long periods of sitting.

Job Type: Full-time

Pay: From $17.00 per hour

Expected hours: 40 per week

Benefits:

  • 401(k)
  • Dental insurance
  • Health insurance
  • Paid time off
  • Vision insurance


Schedule:

  • 8 hour shift
  • Monday to Friday


Experience:

  • Healthcare: 1 year (Preferred)
  • Customer support: 2 years (Preferred)


Work Location: In person



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