Training & Quality Specialist
Posted on: October 18, 2020
Resp & Qualifications
*** Please Note: This position with reside at CASCI in Charleston,
Under the general supervision of the Lead Business
Analyst/Supervisor, the incumbent works as part of a self managed
team with accountabilities that include, but are not limited to,
1. Develops and delivers professional start to finish new hire,
refresher, in service and knowledge or scope expansion training.
Develops and maintains training documentation. Coordinates with
various training areas throughout the organization to assure
consistency and non-duplication of effort. Rapidly learns new or
changing systems, products, and concepts for the purpose of
training and providing support. Provides and fosters positive and
enthusiastic work attitudes through the establishment of precedent
setting work ethics and expectations for quality and
2. Provides knowledge, analytical, technical and decision making
support to front line Customer Service Representative 1, 2 and 3,
Full Service Representatives and Claims Adjusters at time of
delivery. Assists Customer Service Representatives in the
management of case backlogs and organizational skill development.
Adjusts/Processes claims as necessary.
3. Develops and maintains a fair and measurable Quality Assurance
Program. Reviews random samples of telephonic and written provider
service encounters. Provides consistent and constructive feedback
to Customer Service Representatives 1, 2 and 3, Full Service
Representatives and Claims Adjusters regarding the quality of their
performance. Provides analytical and tracking reports to management
for the purpose of performance appraisal and trend analysis. Aids
in the development and deployment of action plans to correct
4. Develops communications through various media to disseminate new
or changing information that is vital to quality customer service.
Works with NMIS auditors to resolve issues related to the
departmental NMIS Quality audit. Participates in various corporate
and departmental initiatives as they relate to the delivery of
quality customer service to providers. Monitors the progress of
requested system changes and performs follow up as required.
Required: a BS in Education or Business, or equivalent work
experience. Two to three years of related customer service and
claims experience. Formal experience with classroom training.
Skills/ Abilities: An understanding of multiple factions of
CareFirst s business, indemnity products and policies. Technical
competence with CareFirst claims and customer service. Excellent
written/verbal communication and coaching/counseling skills. The
ability to interact with various levels of associates and
management. A thorough understanding of instructional design,
lesson planning, adult learning theory and measurement/evaluation
tools is required. Project management and organizational skills are
necessary for the management of multiple priorities. Working
knowledge of CareFirst indemnity claims and service systems,
Microsoft Word, Excel, Powerpoint, Access, and Lotus Notes is
Preferred: Experience in working with self managed teams.
Equal Employment Opportunity
CareFirst BlueCross BlueShield is an Equal Opportunity (EEO)
employer. It is the policy of the Company to provide equal
employment opportunities to all qualified applicants without regard
to race, color, religion, sex, sexual orientation, gender identity,
national origin, age, protected veteran or disabled status, or
Hire Range Disclaimer
Actual salary will be based on relevant job experience and work
Where To Apply
Please visit our website to apply: www.carefirst.com/careers
Please apply before: 10/31/2020
Federal Disc/Physical Demand
Note: The incumbent is required to immediately disclose any
debarment, exclusion, or other event that makes him/her ineligible
to perform work directly or indirectly on Federal health care
The associate is primarily seated while performing the duties of
the position. Occasional walking or standing is required. The hands
are regularly used to write, type, key and handle or feel small
controls and objects. The associate must frequently talk and hear.
Weights up to 25 pounds are occasionally lifted.
Sponsorship in US
Must be eligible to work in the U.S. without Sponsorship
Keywords: CASCI, Charleston , Training & Quality Specialist, Other , Charleston, West Virginia
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