[Hiring] Quality Assurance Specialist @SCAN Health Insurance

Role Description

This role involves ensuring compliance with regulatory and company/departmental standards by monitoring staff and processes, and implementing corrective action as required. It aims to improve service quality and efficiencies by developing and implementing standards, workflows, and processes that are compliant with regulatory requirements and support the delivery of service excellence.

• Maintain regulatory compliance by remaining knowledgeable of regulations and contractual requirements related to customer service operations.
• Develop and implement processes and policies/procedures that meet or exceed requirements.
• Ensure the SCAN commitment of service excellence to customers by ensuring that staff consistently provide a level of service that meets or exceeds customer expectations.
• Identify and remediate deficient practices/processes by monitoring processes and staff interactions with customers.
• 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.
• Support the Member Services Trainer by providing feedback on training needs and assist in the development and presentation of training.
• Maintain awareness of membership and service issues by generating reports and analyzing data to identify trends.
• Contribute to team effort by accomplishing related results as needed.
• Actively support the achievement of SCAN’s Vision and Goals.
• Other duties as assigned.

Qualifications

• Bachelor’s degree
• A comparable combination of education/experience and/or training will be considered equivalent to the education listed above.
• 5+ years’ experience, preferably within the healthcare industry.
• Demonstrated efficiency/effectiveness in an environment with a high call volume.
• 1+ years of prior experience with Medicare benefits, including Medicare Advantage Plans preferred.
• Experience in the healthcare, insurance, or pharmacy industry highly desirable.
• Excellent communication skills, both oral and written.
• Strong interpersonal skills, including excellent verbal communication skills.

Benefits

• Base Pay Range: $45,300-$72,500
• Work Mode: Remote
• An annual employee bonus program
• Robust Wellness Program
• Generous paid-time-off (PTO) - 11 paid holidays per year, 1 floating holiday, birthday off, and 2 volunteer days
• Excellent 401(k) Retirement Saving Plan with employer match
• Robust employee recognition program
• Tuition reimbursement
• An opportunity to become part of a team that makes a difference to our members and our community every day!