QA Associate

ConnectiveRx • Pittsburgh, PA

2d • $19 - $29

About The Position

The Operations Quality Assurance Associate I evaluates work completed by Operations Agents against program SOPs, WINs, business rules, and other program-related documents to ensure adherence to established expectations and internal and external quality standards. The role serves as a subject matter expert for assigned business units and reviews data, processes, and workflows. It also provides actionable coaching to Operations Agents to support quality improvement and operational excellence.

The position includes performing and documenting quality evaluations across operational products and services, partnering with Training, participating in calibration meetings, and escalating critical quality concerns. Occasional evening and/or weekend hours may be required based on business needs.

Requirements

• High school diploma or equivalent; relevant experience may be considered in place of formal education requirements.
• 0–2 years of experience as a Case Manager, Benefit Verification Specialist, Contact Center Agent, or in a similar role.
• Healthcare industry experience in claims processing, contact centers, benefit verification, or related areas is required.
• Working knowledge of quality-focused services, including accuracy management, performance metrics, customer experience, healthcare benefits, and SOP execution.
• Proficiency with Microsoft Office Suite, including Word, Excel, Outlook, SharePoint, and Teams.
• Strong analytical, organizational, and communication skills.
• Ability to provide constructive feedback and coaching.
• Ability to sit, stand, see, hear, speak, and perform repetitive computer and office-related tasks.
• Ability to operate standard office equipment and computer systems.

Nice To Haves

• Experience in healthcare operations, customer service, or quality assurance environments preferred.
• Call center and/or claims processing experience is a plus.
• Bilingual English/Spanish skills are a plus.

Responsibilities

• Coach Operations Agents through peer-to-peer feedback on opportunities identified during quality evaluations.
• Partner with Training to support new hire, refresher, and nesting training programs.
• Perform and document quality assurance evaluations across operational products and services, including benefit verification cases, patient assistance cases, software support calls and emails, inbound calls from patients and healthcare providers, data entry activities, and other operational functions.
• Participate in internal, vendor, and client calibration meetings related to quality initiatives.
• Identify and appropriately escalate critical quality concerns to senior management.
• Support additional quality assurance functions and responsibilities as needed to help achieve department and company goals.
• Be available to work occasional evening and/or weekend hours based on business needs.
• Audit work completed by Operations Agents.
• Perform other duties as assigned.
• Adhere to company policies, procedures, and training requirements related to Information Security and Compliance Programs.
• Maintain compliance with applicable standards and regulations, including SOC1, SOC2, PCI, and HIPAA.
• Follow company and client business rules, ethical standards, and applicable local, state, and federal laws and regulations.

Benefits

• Medical, dental, vision, life, and disability insurance.
• 401(k) plan, with employer contributions where applicable.
• Flexible paid time off (PTO) policy for exempt employees, covering sick days, personal days, and vacations.
• Eight standard company holidays and three floating holidays annually.
• Opportunities for a bonus or commissions.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED