Membership Quality Assurance

Job Summary

This position is responsible for performing quality assurance for production areas and within the quality teams of Membership. Delivering feedback to representatives and leadership staff for appropriate coaching actions. Assisting in evaluation of department policies and procedures and being available to communicate, and assist others, with problem solving, coaching, and process improvements.

Responsibilities

• Identify areas of weakness where additional training may be needed and communicate this information to supervisor/assistant supervisor.
• Meet turnaround times that ensure staff can achieve individual, departmental, and corporate goals (to include MTM targets), and address areas of weakness at the earliest possible time.
• Assist with feedback to supervision on the types of errors made.
• Makes suggestions on procedure clarifications and on tools or resources to improve accuracy levels.
• Enters employee accuracy data into the Membership Accuracy database so reports can be used for performance evaluations and reporting accuracy levels for the unit and department.
• Makes regular appearances with other staff and supervisors to ensure consistency and share ideas for improvement.
• Must be able to serve on cross departmental or cross divisional teams/meetings as needed for supervision regarding quality, additional education, and coaching.
• Maintain oversight of work items being checked to ensure necessary corrections are complete.
• Answer questions on corporate policies, membership procedures, and state and federal laws as applicable to Membership for BCBSKS staff.

Requirements

• Knowledge of Membership systems and ability to perform reviews and inspect new and existing contracts, groups, member and group level maintenance, benefit coding, membership finance transactions, customer service packages, and other items within the membership workflow to determine if correct action was taken.
• Ability to critically think about and analyze Membership policies, procedures, and processes.
• Ability to identify quality control issues on new or changing products, systems, government laws, mandates, and policies at the individual, unit, and department level to improve accuracy of the department and service to customers.
• Responsible for daily reporting accuracy and completion.
• Responsible for participating and possibly leading meetings and other events as it pertains to the quality assurance goals set by the company.
• Ability to communicate with supervision when additional reference materials are needed.
• Ability to maintain productivity standards as outlined, adhere to corporate compliance program and complete annual required trainings, while maintaining confidentiality.

Qualifications

This position is eligible to work onsite at the Topeka campus in accordance with our Telecommuting Policy. Applicants must reside in Kansas or Missouri or be willing to relocate as a condition of employment.