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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 evaluations 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 consistency.
- Identify and communicate trends to leadership based on findings from quality evaluations.
- Evaluate further training requirements and report potential opportunities for additional resources to leadership.
- Assist in organizing and conducting training for new hires and ongoing education.
- Develop new quick reference materials and timely communications for staff.
- Act as a subject-matter expert for direct reports in areas including Medicare Parts A & B, Medicare claims billing, and payments.
Qualifications
- Intermediate to advanced proficiency in Microsoft Word and PowerPoint.
- Basic to intermediate skills in Microsoft Excel.
- Exceptional written and verbal communication abilities.
Experience Requirements
- A minimum of two years of experience in member services, specifically within Medicare Advantage.
- At least one year of experience in a quality assurance capacity.
- A minimum of one year of experience in a training role, including facilitating virtual learning sessions and creating training materials.
