HealthPlanOne · 21 hours ago
Quality Assurance Lead
HealthPlanOne is committed to helping people find the right health insurance at the right price. The Quality Assurance Lead will assist in training QA Specialists, audit work products, and create quality reports while serving as a subject matter expert.
FinanceHealth CareHealth InsuranceInsuranceMarketing
Responsibilities
Create training materials for agents, specialists, and ops leaders
Spot check/audit auditors: randomly audit the work product from the Quality Team
Create and distribute various client and Operations custom reports: Agent QA scores, appeals, other various quality & coaching reports
Participate in client and Account Management meetings to provide input from the Lead’s specific line-of-business
Meet with Operational Leaders to provide calibrations, reporting analysis and training sessions
Attends Operations Supervisor/Agent QA coaching sessions as required to provide additional detail and/or clarity where needed in follow up to the audit and the QA coaching request
Process appeals: Investigate, manually make changes, and document appeal findings
Work side-by-side with internal quality assurance platform developers assisting with debugging, testing, troubleshooting, suggesting process enhancements, etc
Assist with auditor training and alignment: /Ensure auditors stay aligned with material and systems, answering questions
Serve as the dedicated Subject Matter Expert per the line of business
Evaluates/audits calls and evaluate the quality of each call based on the quality guidelines and standards
Score each call based on compliance criteria
Resolve escalated issues with members, carriers and internal clients
Perform other related duties as assigned
Qualification
Required
High school diploma or equivalent
Excellent written and oral communication
Ability to work under set production goals
Accurate data recording
Analytical, organized and detail oriented
Excellent proofreading skills
Knowledge of Excel and Outlook
Knowledge of CMS
Preferred
Associate degree in business or related field
Quality assurance analyst/evaluator experience or a current and valid Life, Health and Annuity License (215)
Exposure to Medicare and other insurance products
Bilingual speaking skills (English and Spanish)
Company
HealthPlanOne
HPOne is a singular vision create custom sales,marketing and contact center solutions exclusively for the health insurance industry.
H1B Sponsorship
HealthPlanOne has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2024 (3)
2021 (2)
Funding
Current Stage
Late StageTotal Funding
$6.5MKey Investors
Pequot Capital
2020-06-22Acquired
2008-04-21Series A· $6.5M
Company data provided by crunchbase