Senior Client Setup Quality Assurance Specialist
3 weeks ago
We are seeking a highly skilled Client Setup Quality Assurance Specialist to join our team at Independence Blue Cross. As a key member of our organization, you will play a critical role in ensuring the quality and accuracy of client setup processes.
Responsibilities:- Participate in internal and external audits to identify areas for improvement and ensure compliance with established guidelines.
- Collaborate with client implementation, sales, and audit teams to understand the scope and timeline of client benefits and setup.
- Identify setup issues, trends, and process improvement opportunities through audit findings and work with the client setup team to implement changes.
- Conduct audits of client setup documents, including benefit templates, and ensure that they are accurate and up-to-date.
- Develop and maintain positive client relationships with internal and external customers and account executives.
- Participate in special projects regarding customer implementation and changes, and recommend process changes to increase departmental efficiency.
- Bachelor's degree preferred, or 3-4 years of relevant experience in lieu of degree.
- Minimum 4 years of relevant experience required, with benefits and claims experience preferred.
- Auditing and quality review experience required, with experience with Health Rules Manager/Designer preferred.
- Considerable knowledge of audit processes and requirements, including organization and storage of documentation.
- Well-versed in best practice processes and procedures, with in-depth knowledge of healthcare products, benefits, and systems.
- Proven effectiveness in managing project targets and deadlines, with demonstrated effective project management skills.
This role is designated as a hybrid model, with associates working in the office 3 days a week and remotely 2 days a week. The work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania.
Independence Blue Cross is an Equal Opportunity and Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
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