Quality Assurance Analyst - Healthcare analyzes quality assurance and compliance data and assists in preparing reports. May assist designing solutions to quality management issues. Being a Quality Assurance Analyst - Healthcare may assist in the implementation of quality improvement processes. May require a bachelor's degree in area of specialty. Additionally, Quality Assurance Analyst - Healthcare typically reports to a supervisor. To be a Quality Assurance Analyst - Healthcare typically requires 0-2 years of related experience. Works on projects/matters of limited complexity in a support role. Work is closely managed. (Copyright 2024 Salary.com)
Summary of Responsibilities:
Responsible for the quality review of day-to-day interactions and correspondence between Client Relationship Center and/or Insurance Profillment Solutions associates and clients. Provides managers with statistical data trends in quality. Identifies potential procedural improvements, process barriers and training needs. Identifies individual quality improvement needs and provides necessary coaching. Provides support for case resolution and training for specialized procedures. Works with minimal supervision and is responsible for making an established range of decisions, escalating to Manager when necessary and updating Manager on a regular basis.
Position Responsibilities:
Performs live and recorded call monitoring of a predetermined percentage of phone interactions, and provides trend and error rate data to Leadership.
Performs quality audits of a predetermined percentage of outgoing written correspondence, emails and live chats, and provides trend and error rate data to Leadership.
Monitors requests and workflow volumes and assigns to appropriate workgroups. Identifies errors and proactively provides necessary feedback and/or coaching.
Provides management with reports and actionable data on monthly results of department quality audits, indicating specific trends and error rates.
Particpates in the development of quality control and monitoring forms, standards and measures for existing and future business needs, interactions, correspondence and processes.
Identifies trends and suggests improvements to processes, procedures and/or training.
Compiles a weekly report at the associate level detailing misdirected requests, requests that should have been handled at the time of the interaction and correspondence error ratios for the purposes of coaching and development.
Demonstrates expertise with all products, procedures and systems within the business unit.
Supports process enhancement implementations.
Provides additional support for other duties as assigned by management.
Selection Criteria:
Proven experience handling and effectively resolving client problems in a contact center environment. Must provide examples of strong customer service skills.
Proven experience mentoring individuals and demonstrating strong interpersonal communication skills. Must cite examples of providing direction, coaching and giving effective feedback to team members.
Demonstrated experience leading and motivating teams in situations associated with high volumes of work and/or customer demands. Must possess strong coaching and effective feedback skills.
Demonstrated mastery of product, policy and procedure knowledge. Demonstrated mastery of efficiently navigating through multiple computer system applications.
Demonstrated experience identifying problems arising from client relation issues and policy/procedures changes, etc., and providing effective recommendations to resolve.
Proven examples of identifying and resolving problems where independent decision-making and self-initiative were demonstrated.
Demonstrated experience maintaining a calm and professional demeanor when handling demanding situations.
Demonstrated experience in completing multiple functions effectively and accurately while maintaining a professional demeanor. Proven experience coordinating multiple projects/assignments simultaneously and completing assigned tasks accurately and on a timely basis.
Demonstrated strong attention to detail with excellent organizational skills. Must provide examples from work experience of maintaining a high degree of accuracy associated with high volumes of work. Must be able to cite examples of organization and prioritization methods for assigned workload.
Proven experience adapting and demonstrating flexibility associated with changes in policies and procedures, as well as meeting both department and client needs.
Possesses and displays excellent verbal and written communication skills with ability to convey detailed information to internal and external clients in a clear, focused and concise manner while following proper rules of punctuation, dictation and style.
Must be able to cite examples of self-motivation and experience working under limited supervision.
Demonstrated experience working effectively within a team.
Work Setting:
Works in an office setting and remains in a continuous stationary position for long periods of time while working at a desk, on a computer or with other standard office equipment, or while in meetings.
Performs substantial movement of wrists, hands and fingers for continuous computer work.
Educational Requirements:
High school diploma or GED.
College experience preferred.
Computer Skills and Knowledge of Hardware & Software Required:
Proven experience with Microsoft Office products including Outlook, Word and Excel. Proficiency in word processing and spreadsheets, and working knowledge of databases is required.
Certifications & Licenses (i.e., Series 6 & 63, CPA, etc.):
None required.
Position Demands:
Extended hours required during peak workloads or special projects.
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