Performance Quality Analyst I

About the role

The Performance Quality Analyst I will be responsible for driving service quality excellence by evaluating the quality of services and interactions provided by organizations within the enterprise. Included are processes related to enrollment and billing and claims processing, as well as customer service written and verbal inquiries. This role requires associates to be in-office 1‑2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work‑life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Responsibilities

• Assists higher level auditor/lead on field work as assigned, including performing special audits and targeted audits as requested by internal management.
• Participates in pre and post implementation audits of providers, claims processing and payment, benefit coding, member and provider inquiries, enrollment & billing transactions and the corrective action plan process.
• Analyzes and interprets data and makes recommendations for change based on judgment and experience, applies audit policy, and assesses risks to minimize exposure and mitigate those risks.
• Documents audit results, documents findings, and suggests appropriate remediation.

Requirements

Requires a BS/BA; 2+ years related experience in an enrollment and billing, claims and/or customer contact automated environment (preferably in healthcare or insurance sector); or any combination of education and experience, which would provide an equivalent background.

Benefits

• Merit increases
• Paid holidays
• Paid Time Off
• Incentive bonus programs (unless covered by a collective bargaining agreement)
• Medical, dental, vision coverage
• Short and long term disability benefits
• 401(k) + match
• Stock purchase plan
• Life insurance
• Wellness programs
• Financial education resources

Schedule

Hybrid work schedule: associates are expected to work in‑office 1‑2 days per week, with the remainder of work performed virtually. Specific on‑site expectations will be discussed during the hiring process.