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Quality Assurance Analyst
2 months ago
The Quality Assurance Specialist is accountable to the Director of Customer Care. In this capacity, you will oversee the evaluation and assessment of member service representatives in accordance with predefined quality standards.
Key Responsibilities
- Deliver training and support to member services and provider services representatives informed by quality assessment outcomes.
- Facilitate training sessions in a virtual environment.
- Perform quality assessments on calls made by member services and provider services.
- Review and audit documentation from the call center.
- Engage in regular calibration sessions with call center staff and management to ensure quality standards are met.
- Identify and report trends to leadership based on findings from quality assessments.
- Evaluate additional training requirements and communicate opportunities for further training resources to management.
- Assist in organizing and conducting training for new hires and ongoing training initiatives.
- Develop quick reference materials and timely communications for staff.
- Act as a subject-matter expert for direct reports regarding Medicare Parts A, B, C, D, claims billing, and payments.
Required Qualifications
- Intermediate to advanced proficiency in Microsoft Word and PowerPoint.
- Basic to intermediate proficiency in Microsoft Excel.
- Exceptional written and verbal communication abilities.
Experience Requirements
- At least two years of experience in member services, specifically within Medicare Advantage.
- A minimum of one year in a quality assurance capacity.
- At least one year of experience in a workplace learning role, including facilitating virtual training sessions and creating learning materials.
