Are you looking for an opportunity to be a solid contributor to the company’s success by applying your tremendous data analysis and administration skills and knowledge? We are looking for a candidate who is seeking a position offering the opportunity to develop new skills within the company. 

The ideal candidate for this role should possess a strong work ethic, excellent communication skills, critical thinking abilities, organizational skills, collaboration skills, character, and self-awareness. The ideal candidate is well versed in the functional knowledge of claims quality assurance, viewed as a team player, and can easily be identified as a team player within their department and the company.

JOB SUMMARY

The Process Control Unit Specialist will focus primarily on reviewing transactions processed by the operations team for accuracy. 

RESPONSIBILITIES

• Responsible for quality monitoring for eligibility determinations and other transactions
• Assists with the development of quality and customer service improvement programs to ensure a qualified, productive, and skilled workforce.
• Provides management with data analysis to identify trends.
• Uses quality monitoring data management system to compile and track performance at team and individual level.
• Assists with oversight of quality monitoring to ensure accurate information is provided to our internal and external stakeholders.
• Identify training opportunities based on monitoring results.
• Coordinates and facilitates refresher training sessions for staff.
• Interprets and communicates operating and quality policies.
• Provides feedback to team Supervisors and managers.
• Provides administrative support for project teams and special projects.
• Knows the formal and informal departmental goals, standards, policies and procedures which may include some familiarity of other departments within the company.
• Other duties assigned by management.

REQUIRED SKILLS/ABILITIES

To perform these jobs successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Excellent oral, written, and interpersonal communication skills
• Medical background preferred.
• Knowledge of Microsoft Office applications
• Exceptional analytical skills
• Strong knowledge of customer care processes and techniques
• Demonstrated ability to work well independently and in a team environment.
• Dedication to providing exceptional customer service.

EDUCATION AND EXPERIENCE

• BA preferred.
• 2 – 3 years Long Term Care experience
• Excellent communication skills both verbal and written are required.
• Ability to interpret contract language.
• Working knowledge of Microsoft Office

PHYSICAL REQUIREMENTS

The physical demands described here are representative of those that must be met by an associates to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the associates is regularly required to sit for prolonged periods of time sitting at a desk working on a computer.  The associate frequently is required to use hands to finger, handle, or feel and reach with hands and arms.  The associates are occasionally required to walk and talk or hear (within normal range).  The associates must regularly lift and/or move up to 10 pounds.  Specific vision abilities required by this job include close vision, and ability to adjust focus.

TO APPLY

Please submit a completed Internal Job Application available on the Rippling Home Page in the Enterprise Policies> Human Resources Policies & Procedures>HR Templates Folder.  Or emails careers.us@chcs-services to request an Internal Job Application. Incomplete applications will not be accepted.Submit your resume and application to Careers.us@chcs-services.com