QC Specialist Operations
About The Position
Renaissance Benefits is hiring a QC Specialist, Operations. This role identifies, analyzes, and recommends process improvements to increase quality and efficiency. It audits claims processing, group implementations, eligibility, and data entry functions, and compiles and analyzes data to assess compliance with quality, production, and performance standards. The specialist develops, prepares, maintains, and distributes productivity and quality-control reports; assists management with inventory reporting; and collaborates with trainers, supervisors, and management on trends identified through quality monitoring. This includes customer service issues, processing concerns, and data errors that may require employee coaching or advanced training. The role also recommends, develops, and controls quality-control production programs and procedures; facilitates action plans to address audit deficiencies; monitors related documentation; identifies employee development needs and assists with training programs; and verifies that department documentation is current and supports quality guidelines. The position is hybrid and located in Indianapolis, Indiana.
Requirements
- Associate's degree, technical, vocational, or business school coursework in business administration, and three years of work experience in a claims processing environment; a suitable combination of education, training, or experience will be accepted.
- Knowledge of dental terminology, procedures, insurance products, and claims processing.
- Advanced knowledge of word processing and spreadsheets.
- Ability to identify process weaknesses and assess how process changes may affect quality.
- Ability to resolve complex problems and exercise independent judgment.
- Effective verbal and written communication skills and organizational skills.
- Ability to collaborate effectively.
- Ability to handle multiple projects and deadlines.
- Ability to recommend improvements that increase quality and efficiency.
Responsibilities
- Audit claims processing, group implementations, eligibility, and data entry functions.
- Compile and analyze data to assess compliance with quality, production, and performance standards.
- Develop, prepare, maintain, and distribute productivity and quality-control reports.
- Identify, analyze, and recommend process or operational improvements to improve efficiency, quality, and effectiveness.
- Assist management staff with inventory reporting.
- Partner with trainers, supervisors, and management on quality-monitoring trends, including customer service issues, processing issues, and data errors that may require coaching or advanced training.
- Recommend, develop, and control quality-control production programs and procedures.
- Initiate and facilitate action plans to address deficiencies identified in audits, and monitor and maintain related documents.
- Recognize and communicate employee development needs and assist with training programs.
- Verify department documentation is current and supports quality guidelines.
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What This Job Offers
Job Type
Full-time
Education Level
Associate degree
