CASY-MSCCN Jobs

The Performance Quality Analyst I is 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 Sales Compensation and Licensing & Credentialing of Broker/Agents, as well as customer service written and verbal inquiries.

How you will make an Impact:

• 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 our exposure and mitigate those risks.

• Documents audit results, documents findings, and suggests appropriate remediation.

Minimum 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.