Quality Assurance and High-Limit Approvals Lead
5 days ago
The Quality Assurance and High-Limit Approvals Lead will oversee the activity and be responsible for the performance of the Quality Assurance and High-Limit Approvals Team staff. This role will develop, implement, and maintain a system of quality for FNHWs products and/or processes.
Key Responsibilities:
1. Assist management in overseeing the daily workflow and schedules of the department.
2. Develop, implement, communicate, and manage processes to ensure that the authorizations department adheres to contract coverage and manages claims cost.
3. Assist authorization management and high-limit approvals with complex cases that require subject-matter expertise and expedited resolution.
4. Manage the leakage tracking spreadsheet and assist with corrections, as needed.
5. Conduct leakage meetings with authorization management.
6. Coordinate and participate in calibration calls with leadership and operations staff.
7. Monitor the approvals view in Zendesk and manage workload.
8. Complete high-limit approvals as needed.
9. Complete QAs as an active QA Analyst on the team.
10. Participate in phone assistance and SWO ownership as needed.
Requirements:
Bachelor's degree in Business, Quality Assurance, or a related field is preferred.
Experience:
Three to five years of experience in a related field is required, with supervisory experience a plus.
Excellent team player with the ability to provide coaching and feedback in a constructive manner and gain buy-in.
Excellent verbal and written communication skills.
Excellent interpersonal and customer service skills.
Excellent organizational skills and attention to detail.
Excellent time management skills with a proven ability to meet deadlines.
Strong analytical and problem-solving skills.
Strong supervisory and leadership skills.
Ability to perform QA Analyst job functions and responsibilities.
Strong understanding of customer service and authorization processes.
Proficiency in MS Office, MS Excel, MS Word, Windows applications, and MS Teams.
Experience with Genesys and PowerBI is a plus.
Additional Information:
This position operates in a clerical office setting. This is largely a sedentary role. The role routinely uses standard office equipment such as computers and phones.
Note:
The statements herein are intended to describe the general nature and level of work being performed by employees assigned to this position. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of this position.
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