Quality Analyst (Premium Healthcare)
Experience: Job Code: REQ-017050
Sagility
Quezon City
job Details
Job title
Quality Analyst (Premium Healthcare)
About Sagility
Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.
Job title:
Job Description:
Education :
High School Diploma or G.E.D. required
Six-Sigma green belt training helpful
Experience:
2+ years’ customer service experience required
Previous experience with high quality performance and review parameter
Working knowledge of Microsoft Office applications
Mandatory Skills:
Excellent organizational and planning skills
Excellent written and oral communication skills
Excellent interpersonal skills and professionalism
Preferred Skills:
Experience analyzing and interpreting data and recommending solutions
Strong analytical and organizational skills preferred
Detail oriented
Ability to manage multiple priorities and deadlines
Excellent communication skills, both written and verbal
Ability to function in a production environment while maintaining high quality results
Ability to make sound, independent judgments and decisions
Ability to influence others through the use of data
Experience analyzing and interpreting data and recommending solutions
Strong analytical and organizational skills preferred
Detail oriented
Ability to manage multiple priorities and deadlines
Excellent communication skills, both written and verbal
Ability to function in a production environment while maintaining high quality results
Ability to make sound, independent judgments and decisions
Ability to influence others through the use of data
Roles & responsibilities :
Review calls, emails, and chats for accuracy and identify opportunities analyze trends from call listening sessions, Identify and recommend improvements in processing and procedures and assist in the development of audit guidelines
Act as a subject matter expert and a resource for team members
Actively engage in quality initiatives to address error trends and process improvement
Facilitate national and site level calibrations and client calibrations,
Use various tools, methods and information sources to create analyses that identify any customer service deficiencies
Utilize the results of the above analyses to champion and coordinate remediation or proactive initiatives to improve quality
Serve as SME for technical questions and works to ensure standards are being met
Represent the team in internal and external audits
Drive the success of quality performance by identifying key opportunities to improve process flows and recognizing potential knowledge gaps at the individual/site level
Assess problems with client or systemic processes to mitigate any impact to our members.
Observe Supervisors’ scoring and provide findings to ensure scoring consistency
Conduct test calls, focus groups, and targeted audits or call monitors as necessary to identify trends and opportunities for quality improvements in a complete, accurate, and timely manner.
Location: