QA Associate
2 weeks ago
Overview:
The Operations Quality Assurance Associate I will evaluate work completed by Operations agents against program SOPs, WINs, business rules, and other program-related documents for adherence to expectations outlined in the documents.
The QA Associate I must be able to use objective decision-making and critical thinking skills to determine whether audited work meets internal and external expectations. The Operations Quality Assurance Associate I will be a subject matter expert for their respective assigned business unit(s) and will utilize analytical skills to analyze data, processes, and workflows to provide insightful, actionable coaching for the Operations Agents.
Responsibilities:What you will do:
- Coach Operations agents (peer to peer) on areas of opportunity for improvement found during evaluations, collaborate with training for Operations agents (i.e., new hire, refresher, and nesting training)
- Performs and documents results of all quality assurance evaluations on all operational products and services, including (but not limited to) benefit verification cases, patient assistance cases, software support calls/emails, inbound calls from patients or health care providers, data entry, etc.
- Participates in internal, vendor, or client calibration meetings as required to address quality initiatives but does not lead them
- Identifies and escalates critical quality issues appropriately to senior management
- Assists with other QA-related functions and responsibilities as needed to meet department and company goals
- Availability to work occasional evening and/or weekend hours to meet company and departmental goals as the business need arises
- Auditing work completed by Operations agents
- Sending feedback to Operations leadership on agent performance
- Attending meetings, helping with data analysis, and other duties as assigned
Qualifications:
What we need from you:
- Highschool or relevant experience
- 1 3 years as a Case Manager, Benefit Verification Specialist, or Contact Center agent at ConnectiveRx, or equivalent experience in a similar role in another company, or 1 3 years of prior quality control experience
- Moderate Excel ability (data validation, data entry, tables, simple formulas) Experience with technical writing (e.g., SOPs, User Manuals, Work Instructions), typing, and PowerPoint ability.
- Knowledge Solid working knowledge of quality-orientated services such as accuracy management, performance metrics, customer experience/satisfaction, healthcare benefits, and SOP execution. Health Care Experience is required, specifically claim processing, contact center, benefit verification, or similar industry experience. Call Center and/or Claim Processing experience is a plus.
- Problem-solving, results-oriented, active listening, and high attention to detail. Monitor telephone calls and communications between The Customer and The Customer Care Center. A strong understanding of empathy across the Customer Care Center is required in all patient interactions. Ensure provision of exceptional customer service required in customer care case management engagement. Work in a matrix environment requiring strong collaboration skills.