Quality Assurance Analyst – Enrollment Billing at Bright Health
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Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes.
What drives our mission? The company values we live and breathe every day. We keep it simple: Be Brave. Be Brilliant. Be Accountable. Be Inclusive. Be Collaborative.
If you share our passion for changing healthcare so all people can live healthy, brighter lives – apply to join our team.
SCOPE OF ROLE
The Quality Assurance Analyst (Enrollment & Billing) assists and coaches individuals on the MES Team to ensure that all individuals are providing exceptional customer service for our Bright customers.
The Quality Assurance Analyst (Enrollment & Billing) job description is intended to point out major responsibilities within the role, but it is not limited to these items.
- Utilize knowledge of State-based exchange, Federal Facilitated Marketplace (FFM) and Brighthealth procedures to accurately evaluate telephone, email and contact center interactions for alignment with defined processes and procedures; meets established goals and metrics, as business needs require.
- Provide training and guidance, verbally and in writing, to associates and Supervisors related to areas of opportunity; share best practices.
- Participate in the discovery and resolution of root cause(s) of recurring issues; Isolate, replicate and document defects and suggest alternatives to provide better outcomes.
- Daily, Weekly, and Monthly Reporting.
- Assist with Escalated calls.
- Other duties and responsibilities as assigned.
EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE
- High School diploma or GED required.
- Two (2) years experience in a customer service role required
- One (1) year experience in a lead or supervisor role preferred
- One (1) year experience auditing transaction (phone, email, chat, etc) and providing constructive feedback required, preferably in the healthcare and/or in a high-volume contact center environment
- Working knowledge and/or experience working with Individual Family Health Plans (IFP), Federally Facilitated Marketplace (FFM), the Affordable Care Act (ACA), or experience in a related healthcare industry preferred.
- Basic computer skills, inclusive of Microsoft office required.
- Must be detailed oriented and present critical analytical thinking skills
- Must display active listening skills
- Organized and be able to prioritize work to meet deadlines
- Collaborate effectively with internal and external partners to resolve issues for our members.
- Must present strong ability to read and comprehend material presented both orally and in writing
- Strong communication skills, both verbal and written
- Comfortable applying basic math skills
- Works independently with little supervision
- Able to thrive and adapt in a fast paced, stressful environment
- Must be flexible to change and open to learning new tasks as assigned
- Must have intermediate skills using Microsoft Office, along with general computer and typing skills
LICENSURES AND CERTIFICATIONS
Producer licensing for Health & Accident may be required in the state in which an individual resides for OEP 2020 or before an individual will be able to transition into a FTE MES role. (Potential temp to FTE is a minimum of 6 months.)
The majority of work responsibilities are performed in an open office setting, carrying out detailed work sitting at a desk/table and working on the computer. Travel may be required.
We understand patient pain points, eliminating complexity while increasing transparency, for greater access and easier navigation.
We integrate and align individual incentives at all levels, from financing to optimization to delivery of care.