Quality Assurance Specialist
7 days ago
Sutherland is seeking an attentive and analytical person to join us as a Quality Analyst.
The Quality Analyst is a front-line position responsible for the evaluation and documentation of customer transactions to ensure accurate and consistent information is provided to customers. The Quality Specialist's key focus is to evaluate transactions to ensure all required processes and guidelines are followed to deliver the highest levels of customer experience and employee engagement while driving KPI performance at or above all critical goals.
This individual is responsible for completing all assigned transaction evaluations and attending all internal and external calibration sessions as assigned.
The work in scope involves auditing transactions (not limited to):
- Patient Care: Coordinating cases from multiple providers and helping injured patients who may not be able to manage their care on their own.
- Manage Administrative Responsibilities: Helping patients with tasks like scheduling diagnostics (care coordinator activities).
- Diagnostics: Voice & Back office work includes reviewing prescription orders, requests for authorization from providers, and pre-screening of patients that will undergo diagnostic exams. The role requires strong clinical knowledge, attention to detail, and effective communication skills to collaborate with various stakeholders.
Quality Analyst in this role gets to:
- Define Sutherland's Reputation: Oversee and manage performance and service quality to guarantee customer satisfaction.
- Strengthen Relationships: Establish and maintain communication with clients and/or team members; understand needs, resolve issues, and meet expectations.
- Keep Management Updated: Relay important information in the form of timely and accurate reports.
- Impact the Bottom Line: Produce solid and effective strategies based on accurate and meaningful data reports and analysis and/or keen observations.
Our most successful candidate will have:
- Minimum 24 months of healthcare/workers comp experience managing customer-facing accounts, preferably managing processes such as intake, scheduling, credentialing, and medical bill reviews.
- PHRN.
- Six months of experience in process transformation/quality (prior experience in care management will be an added advantage).
Ability to work in MS Office and in a fast-paced environment.
Proactive ability in developing trust and professional rapport with employees and team members; work as a team player.
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