[Hiring] Seasonal Customer Service Quality Policy Analyst I @ASM Research

Role Description

The Seasonal Customer Service Quality Policy Analyst I plays a significant role on a fully remote team supporting case analysis and reconciliation of data from the health insurance exchange. Each Analyst must be able to work independently and maintain the confidentiality of the information they encounter. They must be flexible and engaged to meet daily expectations and adapt to changes in casework. A successful candidate should be proactive, exercise good judgment, and demonstrate strong initiative, as most cases are unique in nature and require close attention to detail.

Key Responsibilities:

• Efficient, timely troubleshooting, remediation, coordination, escalation, tracking, and management of complex consumer enrollment disputes.
• Conducting research and workflow investigations, reviewing business procedures, and recommending improvements to the casework adjudication process.
• Identifying and solving customer information and processing problems.
• Applying triage, research, collaboration, and technical knowledge to resolve transaction and processing issues.
• Analyzing discrepancies in the eligibility reconciliation process for multiple stakeholders.
• Serving as a subject matter expert regarding the Health Insurance Marketplace.
• Providing day-to-day guidance to assigned team members when appropriate.
• Coordinating with technical and development teams to resolve identified issues in a timely manner.
• Reviewing documented training material for accuracy and assisting with end-user training and support.
• Driving continuous process improvement of the reconciliation process.
• Providing content for, and collaborating with, training staff to train stakeholders on transaction triage and the reconciliation process.
• Processing 834 file submissions through Advanced Resolution.
• Undertaking additional duties as assigned by the Manager.

What a Typical Day Looks Like:

• Morning: Case Review & Triage - Review assigned caseload and new escalations, triaging cases based on urgency and complexity.
• Midday: Investigation & Problem-Solving - Reconcile eligibility records, trace discrepancies, and troubleshoot issues independently.
• Afternoon: Coordination & Collaboration - Coordinate with technical teams, provide guidance to teammates, and contribute to training materials.
• Throughout the Day: Documentation & Process Improvement - Identify patterns and recommend improvements to enhance workflow efficiency.

What Makes Someone Successful in This Role:

• Comfortable with ambiguity and able to research and make informed decisions.
• Detail-oriented, as small discrepancies can have significant consequences.
• Self-directed with accountability for caseload in a remote environment.
• A natural communicator, able to translate technical issues into plain language.
• Trustworthy with sensitive information, handling confidential consumer data daily.
• Enjoys investigative problem-solving over repetitive tasks.

Qualifications

• Associates Degree OR High School Diploma/GED and 2 years of relevant experience.
• 2 years additional relevant experience.
• Must be a US Citizen.
• Must be able to pass federal background investigation that grants access to government systems.

Preferred Qualifications

• Experience with the Affordable Care Act.
• Strong written and oral communication skills.
• Advanced customer service telephone skills with willingness to make outbound and receive inbound calls.
• Experience with complex data analytics and advanced problem solving.
• Proficiency in Microsoft Word, Excel, PowerPoint, and SharePoint.
• Experience with Federal contracts desired.
• Experience with the 834 enrollment transaction process desired.
• Ability to remain engaged in a remote work environment.

Compensation Ranges

Compensation ranges for ASM Research positions vary depending on multiple factors, including but not limited to location, skill set, level of education, certifications, client requirements, contract-specific affordability, government clearance and investigation level, and years of experience. The compensation displayed for this role is a general guideline based on these factors and is unique to each role. Monetary compensation is one component of ASM's overall compensation and benefits package for employees.

EEO Requirements

It is the policy of ASM that an individual's race, color, religion, sex, disability, age, sexual orientation or national origin are not and will not be considered in any personnel or management decisions. We affirm our commitment to these fundamental policies. All recruiting, hiring, training, and promoting for all job classifications is done without regard to race, color, religion, sex, disability, or age. All decisions on employment are made to abide by the principle of equal employment.

Physical Requirements

The physical requirements described in "Knowledge, Skills and Abilities" above are representative of those which must be met by an employee to successfully perform the primary functions of this job. Reasonable accommodations may be made to enable individuals with qualifying disabilities, who are otherwise qualified, to perform the primary functions.

Disclaimer

The preceding job description has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this job.