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Provider Data Quality Assurance Specialist
2 months ago
We are seeking a highly skilled Quality Assurance Specialist to join our team at Blue Cross and Blue Shield of Louisiana. As a Quality Assurance Specialist, you will play a critical role in ensuring the accuracy and quality of provider data, while also providing guidance and support to the Provider Data Management team.
Key Responsibilities- Perform audits and reports errors in accordance with departmental process and SLAs for all team members on the Provider Data Management team to measure provider data accuracy and precision.
- Identify trends, recommend changes to processes including workflows, assess process deficiencies, and conducts one on one coaching and training.
- Produces daily educational bulletins to enhance quality as needed.
- Mentors and coaches new/more junior staff to educate and inform them on accreditation and regulatory standards.
- Works with business units in conducting gap analysis and/or review data/metrics to determine if a training solution is needed and if so, identifies what type of training is required.
- Participates in cross-functional meetings and work group sessions to identify improvement opportunities and ways to improve quality trend outcomes.
- Assists Supervisor and the Training Coordinator with the modification of training resources/schedules in response to staffing issues and/or business needs.
- Monitors provisions and make recommendations to Service Level Agreements (SLAs) to ensure quality goals are met.
- Partners with the Provider Data Operations team to ensure the integrity of the end-to-end process is met within the provider data repository, PNO.
- High School Diploma is required.
- Bachelor's degree in business or a related field is preferred.
- 2 years of data quality review or audit experience is required; preferably in Provider Data Management.
- Effective verbal and written communication skills are required.
- Must demonstrate the ability to work well within a team.
- Must demonstrate professional and ethical business practices, adherence to company standards, and a commitment to personal and professional development.
- Proven time management skills are necessary.
- Must demonstrate the ability to manage multiple priorities, deliver timely and accurate work products with a customer service focus, and respond with a sense of urgency as required.
