Senior Quality Specialist

Job Summary

Acting as a quality champion in a full-time remote capacity, the Senior Quality Specialist will guide the business by measuring and monitoring the quality and effectiveness of claim processing and customer service to enhance customer satisfaction and operational efficiency.

Key responsibilities

• Conduct regular quality audits for service operations across multiple products and platforms to ensure compliance with standards
• Consult cross-functionally to influence change and promote quality service delivery to internal and external customers
• Support targeted quality audit projects, reporting results and recommending training needs and quality controls to senior management

Required qualifications

• 2+ years of health insurance work experience and/or Healthcare Insurance Quality Review
• 2+ years of experience with diagnosis codes and medical terminology
• Moderate to advanced knowledge of Excel, including V-lookups, pivot tables, and formulas
• High School Diploma or equivalent GED