Job Title: Quality Audit Specialist
Job Location: Nashville, TN (Remote)
Job Duration: 04 Months Contract (possible extension)
Summary:
Completes day-to-day Quality Review and Audit tasks of Telesales Agents that align to CMS rules and regulations when interacting with a Medicare beneficiary. May assist in more complex audits when necessary. Tasks involve a high degree of time management, forward planning and anticipation of needs/issues.
Responsibilities:
- Perform “live” call monitoring of Telesales Agents to ensure CMS compliance guidelines are achieved
- Review and evaluate recorded call interactions between internal agent and customer
- Maintain reporting metrics as a tracking resource
- Provide feedback to Supervisors and Managers regarding Agent performance and compliance adherence
- Provides support locating calls recordings to departments within Medicare Growth organization
- Performs additional audit assignments as directed by Direct-to-Consumer Leadership
- Provides training as needed to Agents regarding telephonic evaluations
- Ensures that Direct-to-Consumer agents adhere to CMS filed telephonic scripts and agent workflows
- Collaborate with peers to ensure consistency in Agent workflows and processes
- Track and trend monitoring results to identify risks/determine areas of improvement
- Drives strong quality audit results; resolves sources of audit issues and translates to effective training, coaching, mentoring and process improvement.
Qualifications:
- High School Diploma and 3 or more years work related experience required, Bachelor’s Degree highly preferred
- Experience working in a Telesales environment during the CMS Annual Enrollment Period
- Knowledge of CMS compliance policies and procedures preferred
- High attention to detail, quality and accuracy required
- Strong coordination and organizational skills and ability to communicate effectively and follow-up where needed
- Fast-learner and multi-tasking skills
- Ability to work independently and within a team environment in a matrixed environment required
- Strong interpersonal and prioritization skills preferred
- Sales and/or training experience recommended
- Excellent listening, written and verbal communication skills required
- Adaptability, flexibility, and ability to manage through change in a fast-paced environment required.
Requirements:
- Health and Accident Insurance License
- Must be available to work a flexible schedule that may include weekends and the day after Thanksgiving.
- AHIP/Medicare Certification
- Internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
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