Quality Assurance Specialist

SCAN Health Insurance•California, MO

1d•Remote

About The Position

Ensure compliance with regulatory and company/departmental standards by monitoring staff and processes, and implementing corrective action, as required. Improves service quality and efficiencies by developing and implementing standards, workflows and processes that are compliant with regulatory requirements and supports the delivery of service excellence.

Requirements

Demonstrated efficiency/effectiveness in an environment with a high call volume
Excellent communication skills, both oral and written.
Strong interpersonal skills, including excellent verbal communication skills.
We seek Rebels who are curious about AI and its power to transform how we operate and serve our members.

Nice To Haves

Bachelor’s degree
5+ years’ preferably within healthcare industry.
1+ years of prior experience with Medicare benefits, including Medicare Advantage Plans preferred
Experience in the healthcare, insurance or pharmacy industry highly desirable.

Responsibilities

Maintain regulatory compliance by remaining knowledgeable of regulations and contractual requirements related to customer service operations, developing and implementing processes and policies/procedures that meet or exceed requirements.
Ensure the SCAN commitment of service excellence to our customers by ensuring that staff consistently provide a level of service that meets or exceeds the customer’s expectation while being respectful, kind and knowledgeable about SCAN benefits and services.
Identify and remediate deficient practices/processes by monitoring processes and staff interactions with customers, providing feedback, identifying trends and overseeing and measuring corrective actions.
Provide management with feedback on staff performance and participate in coaching of the staff.
Improve service quality by measuring the quality, effectiveness and efficiency of the customer experience and provide recommendations for improvement to management.
Support the Member Services Trainer by providing feedback on training needs and assist in the development and presentation of training, as required.
Maintain awareness of membership and service issues by generating reports, analyzing data to identify trends, and making recommendations for improvement.
Contribute to team effort by accomplishing related results, as needed.
Actively support the achievement of SCAN’s Vision and Goals.
Other duties as assigned.