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Training & Quality Specialist

Company: CASCI
Location: Charleston
Posted on: October 18, 2020

Job Description:

Resp & Qualifications

*** Please Note: This position with reside at CASCI in Charleston, WV. ***



PRINCIPAL ACCOUNTABILITIES:
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, the following:


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 productivity.

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 quality issues.

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.

QUALIFICATION REQUIREMENTS:

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 necessary.

Preferred: Experience in working with self managed teams.



Department

Department:

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 genetic information.

Hire Range Disclaimer

Actual salary will be based on relevant job experience and work history.

Where To Apply

Please visit our website to apply: www.carefirst.com/careers (http://www.carefirst.com)

Closing Date

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 programs.

PHYSICAL DEMANDS:

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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