Benefit Specialist

8 hours ago


Pittsburgh, United States Integrated Resources Full time
Job Title: Benefit Specialist
Location: Pittsburgh, PA
Duration: 5+ Months (Possibility of Extension)

Job Description
  • 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
Education:
  • Highschool or relevant experience
  • 1 - 3 years as a Case Manager, Benefit Verification Specialist, or Contact Center agent at client, 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.

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