Quality Analyst

hace 1 semana

Ciudad de México UST A tiempo completo

**Call Center - Quality Analyst**

**Associate III - BPM
**Who we are**:
UST HealthProof is a dynamic company with a mission to lower the cost of care and deliver the future of healthcare. Our consumer-centric approach gives our health plan customers a modern infrastructure and reduced administrative costs, helping to drive better business results for our customers — and better outcomes for our communities.

**You Are**:
**The Opportunity**:

- Conduct silent monitoring and scoring of a sample of calls for each Call Agent.
- Provide scorecard feedback to agents and coach them to increase quality awareness
- Partner with the leadership team and trainers to identify areas of opportunity for training
- Be responsible for designing a reporting mechanism to roll up each customer quality SLA score into a UST business operations quality metric
- Compile audit results from multiple parties and present quality reports, trending, root cause analysis, and identifying opportunities for improvement
- Receive, review, edit, validate the accuracy and integrity of critical data fields, update, and manage documents
- Perform audits of transactions processed by health plan administration associates for cross-functional processes, multiple customers, or transaction types.
- Be responsible for measuring compliance of operations with all identified contractual KPIs CPIs and SLAs.
- Monthly Login to our phone system as an agent to receive and handle calls from our clients. Minimum twenty calls per month. This position is critical to overall operational compliance with the Government (federal and state agencies); the Analyst must immediately report suspected, identified or otherwise known compliance infractions, confidentiality, and security breaches of sensitive customer information.

This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.

**What you need**:

- Experience processing documentation in an administrative capacity
- Intermediate level of proficiency in Word (including use of headers/footers, page formatting, templates and creation of step numbering) and PowerPoint
- Advanced level of proficiency in MS Excel
- Familiarity with applicable health plan operations or document management systems and concepts
- Extremely high level of attention to detail
- Strong written and verbal communication skills
- Ability to adapt and work both independently and collaboratively in a fast-paced dynamic environment
- Ability to effectively and efficiently prioritize assignments and workload
- Good understanding and ability to analyze contractual SLAs and KPIs
- Familiarity with applicable health plan operations or document management systems and concepts
- Extremely high level of attention to detail and Strong written and verbal communication skills
- 3 - 5 years of experience in a related operational area (e.g. claims, billing, customer service, etc.)
- High school degree required; Bachelor’s degree preferred with three (3) plus years of relevant professional experience in Healthcare claims operations for a large national/regional or Blues health plan or insurance company and/or TPA.
- Previous Health Care Call Center/Customer Service Experience.
- Must be able to work with mínimal supervision and have great attendance.
- Excellent verbal and written communication skills.

**What we believe**:
We’re proud to embrace the same values that have shaped UST HealthProof since the beginning. Since day one, we’ve been building enduring relationships and a culture of integrity. And today, it's those same values that are inspiring us to encourage innovation from everyone, to champion diversity and inclusion, and to place people at the center of everything we do.

**Humility**:
We will listen, learn, be empathetic, and help selflessly in our interactions with everyone.

**Humanity**:
Through business, we will better the lives of those less fortunate than ourselves.

**Integrity**:
We honor our commitments and act with responsibility in all our relationships.

**Equal Employment Opportunity Statement
**UST HealthProof is an Equal Opportunity Employer.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

UST HealthProof reserves the right to periodically redefine your roles and responsibilities based on the requirements of the organization and/or your performance.

USTHealthproof

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