| WHAT YOU’LL DO:Monitor, review and/or evaluate the quality of service provided by department staff to measure service quality and identify non-conformance while maintaining production and time service goals. On a regular basis, provide regular coaching and feedback to individual staff. May schedule staff to assure adequate/required service level coverage for customers.May review and/or handle appeals and/or elevated issues as appropriate.May validate accuracy of decisions/processes for adherence to set standards and/or applicable regulations or requirements. May work with external parties for resolution.May prepare reports of quality results for use by management in evaluating performance or developing training.May perform standard premium and eligibility processing functions.Maintains confidentiality in the collection, maintenance and dissemination of restricted, sensitive or other information as identified by management.Establishes and maintains effective working relationships with personnel at all levels of the Company to assure the successful implementation and delivery of programs.May determine and recommend billing and enrollment alternatives to support non-standard requests to establish processes and systems. This job posting is reflective of the Quality Audit Representative essential functions, qualifications, and physical requirements. The Sr Quality Audit Rep level has variable essential functions, qualifications and physical requirements. Competency and skill set will determine level of placement within the posted job family. |
| ABOUT YOU:You help promote a culture of diversity and inclusion within the department and the larger organization. You value different ideas and opinions. You listen courageously and remain curious in all that you do.You are able to work remotely and have access to high-speed internet.Strong Customer Service skills and ability to work effectively with others through effective verbal and written communication.Strong teamwork, collaboration and flexibility.Thorough knowledge of one or more of the Company’s product lines.Strong analytical ability, sound judgment and math aptitude.Thorough knowledge of applicable laws and regulationsAbility to work well under pressure and deadlinesProficient with personal computer and software applications/data entryMicrosoft Word and ExcelGood oral and written communication skills and the ability to effectively articulate instructions and information to other associatesSome knowledge/skill in presentation |
| VALUABLE EXPERIENCE:Experience with Compass system and GSAP (Group Sales Application)EDI experience Knowledge of eligibility rules.Strong knowledge of Group Insurance. |
| WHAT WE CAN OFFER YOU:Salary Range: Minimum: $19.50 – $27.00/hourPay commensurate with experience. |
