Associate, Operations QA

The Associate, Contact Center Quality is a role that assesses the quality of engagement / service but also influence future performance through direct and comprehensive feedback to those individuals providing said services. This individual may have primary responsibilities for one or more of the following: assessing quality of our customer engagements; claim reimbursement efforts.

What You Will Do:

• Monitors telephone calls and other communications between the patients and the Customer Care Center. This position requires someone with a strongly embedded understanding of the goal of a culture of empathy across the Customer Care Center that is to be transmitted and communicated in all patient interactions and as well as the provision of exceptional customer service required in patient care/health care case management engagement.

• Participation in calibration sessions with business partners to ensure quality expectations are being met and program compliance.

• Work in conjunction with training to ensure QA participation with new programs, new hire classes on existing programs and/or changes to programs.

• Maintain positive, consistent and effective communication with associates, peers and leadership teams.

• Identify, communicate and monitor trends and quality risks and serve as a resource regarding quality concerns or issues

• QA feedback will be provided during coaching sessions utilizing the GROW Coach Module

• QA Call/Claim review

• Quality Call & Claim guideline review

• Agent top trends

• 
  

What We Need From You:

• High School Diploma or equivalent.

• Experience 1 to 3 years in a quality assurance or quality auditing role preferably in a call center environment. in high volume call centers.

• Experience in pharmacy benefits and health care insurances a major plus. Medical billing background a plus.

• Problem solving, results orientated, active listening and high level of attention to detail.

• Solid working knowledge of quality orientated services such as accuracy management, performance metrics, customer experience/satisfaction, and SOP execution.

• Health Care Experience specifically claim processing, contact center, or similar industry experience is required. Call Center & / or Claim Processing experience is a plus.

• Intermediate understanding of all Microsoft Office Products (Excel, Word, PowerPoint, etc..).

• Very strong verbal and written communication skills to enable relationships across all levels of the organization. Fluent in English/Spanish (a plus).

• Strong organizational skills.

• Must have an extreme sense of patient/customer empathy

• Exceptional customer service required in customer care case management engagement.

• Work in a matrix environment requiring strong collaboration skills.

Travel:

Work is hybrid and you will need to come in to the office few days every week.