Claims Quality Analyst

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.

The purpose of this role is to promote excellent call quality, contact handling and documentation by providing an additional consistent monitoring measurement.

Job title:

Claims Quality Analyst

Job Description:

Education:

High School Graduate is required

Experience:

Min 1-2 years of experience in a call center managing the inbound calls (same experience needed in Claims process in case of back office)

Mandatory Skills:


* Must be good in coaching skills (for coaching the CSR based on their call quality)


* Must be proficient in typing speed


* Excellent written and verbal communication skills


* Excellent time management skills


* Strong keyboarding/computer skills, including Microsoft Word and Excel


* Must be detail oriented with good observation skills.

Roles & Responsibilities:


* Remotely monitors customer service skills of all customer service representatives to ensure quality of call handling, accurate coding in CRS and making appropriate documentation.


* Completes established monitoring objectives in accordance with applicable SOP?s.


* Provides written and oral feedback to the CSR on all calls monitored.


* Completes daily statistical reports and spreadsheets according to standard procedure.


* Completes Quality Control Reports as assigned on a daily basis, makes corrections to CRS when errors exist and documents the contact.


* Attends weekly and monthly department meetings to calibrate monitoring measurements.


* Notifies management immediately of serious infractions in a Customer Service Representative?s call quality.


* Follows all client SOP?s and applicable work related guidance documents.


* Responsibilities may include taking Supervisory calls and escalations.


* Ensure daily / weekly / monthly audit targets are met.


* Ensure audits are completed as per client requirements and ATA is maintained.


* Ensure to take calls whenever needed as specified by the manager.

Salary: $18.00 and up dependent on experience and location

Sagility Offers Competitive Benefits Including:


* Medical


* Dental


* Vision


* Life Insurance


* Short-Term and Long-Term Disability


* Flexible Spending Account


* Life Assistance Program


* 401K with employer contribution


* PTO and Sick Time


* Tuition Reimbursement

Join our team, we look forward to talking with you!

An Equal Opportunity Employer/Vet/Disability

Location:

Work@Home USAUnited States of America