QA Associate

Pdr Corporation • Pittsburgh, PA

209d

About The Position

The Operations Quality Assurance Associate I will evaluate work completed by Operations agents against program SOPs, WINs, business rules, and other program-related documents for adherence to expectations outlined in the documents. The QA Associate I must be able to use objective decision-making and critical thinking skills to determine whether audited work meets internal and external expectations. The Operations Quality Assurance Associate I will be a subject matter expert for their respective assigned business unit(s) and will utilize analytical skills to analyze data, processes, and workflows to provide insightful, actionable coaching for the Operations Agents.

Requirements

• High school or relevant experience
• 1 - 3 years as a Case Manager, Benefit Verification Specialist, or Contact Center agent at ConnectiveRx, or equivalent experience in a similar role in another company, or 1 - 3 years of prior quality control experience
• Moderate Excel ability (data validation, data entry, tables, simple formulas)
• Experience with technical writing (e.g., SOPs, User Manuals, Work Instructions), typing, and PowerPoint ability.

Nice To Haves

• Solid working knowledge of quality-orientated services such as accuracy management, performance metrics, customer experience/satisfaction, healthcare benefits, and SOP execution
• Health Care Experience is required, specifically claim processing, contact center, benefit verification, or similar industry experience
• Call Center and/or Claim Processing experience is a plus
• Problem-solving, results-oriented, active listening, and high attention to detail.
• Monitor telephone calls and communications between The Customer and The Customer Care Center.
• A strong understanding of empathy across the Customer Care Center is required in all patient interactions.
• Ensure provision of exceptional customer service required in customer care case management engagement.
• Work in a matrix environment requiring strong collaboration skills.

Responsibilities

• Coach Operations agents (peer to peer) on areas of opportunity for improvement found during evaluations, collaborate with training for Operations agents (i.e., new hire, refresher, and nesting training)
• Perform and document results of all quality assurance evaluations on all operational products and services, including benefit verification cases, patient assistance cases, software support calls/emails, inbound calls from patients or health care providers, data entry, etc.
• Participate in internal, vendor, or client calibration meetings as required to address quality initiatives but does not lead them
• Identify and escalate critical quality issues appropriately to senior management
• Assist with other QA-related functions and responsibilities as needed to meet department and company goals
• Availability to work occasional evening and/or weekend hours to meet company and departmental goals as the business need arises
• Audit work completed by Operations agents
• Send feedback to Operations leadership on agent performance
• Attend meetings, help with data analysis, and perform other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Professional, Scientific, and Technical Services
• Education Level: High school or GED