Quality Analyst
2 weeks ago
The Quality Analyst plays a vital role in maintaining and improving the service quality within the healthcare contact center. This position is responsible for monitoring and evaluating the accuracy and compliance of agents' approvals on customer requests, validating Excess of Benefits (EOB), and ensuring adherence to quality standards across both voice and non-voice channels. The QA Analyst also provides coaching, conducts regular calibrations, and delivers actionable insights and reports to drive performance excellence.
Key Responsibilities:
- Review and verify customer request approvals made by contact center agents to ensure they align with internal policies and healthcare protocols.
- Validate Excess of Benefits (EOB) cases and ensure proper documentation and resolution are reflected in each transaction.
- Monitor and evaluate agent interactions (calls, emails, chat, etc.) using standardized scorecards and quality metrics to ensure compliance, accuracy, and customer satisfaction.
- Conduct weekly one-on-one quality coaching sessions with agents to provide performance feedback, reinforce strengths, and identify areas for improvement.
- Coordinate and lead regular calibration sessions with team leaders and trainers to align on quality standards, scoring criteria, and compliance expectations.
- Generate and present quality performance reports, trend analyses, and QA dashboards to the Operations Head/Project Manager, identifying risks, process gaps, and improvement opportunities.
- Work closely with operations, training, and compliance teams to support continuous quality improvement and ensure best practices are implemented.
Qualifications:
- Bachelor's degree in Nursing, Healthcare Administration, Business, or related field preferred
- At least 1-2 years of experience in a contact center QA role, preferably in the local healthcare industry
- Strong understanding of healthcare processes, benefits validation, and regulatory compliance
- Excellent communication, coaching, and analytical skills
- Proficient in QA tools, reporting platforms (e.g., Excel, Google Sheets), and CRM/ticketing systems
- Detail-oriented and organized with the ability to manage multiple tasks in a fast-paced environment
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