Chickasaw Nation Industries

  • Quality Assurance Analyst III

    Job Locations US-OK-Oklahoma City
    Job ID
    2018-5718
    Category
    Administrative/Clerical
    Full-Time/Part-Time
    Full-Time
  • Overview

    ***Position open to internal employees only***  In support of the Centers for Medicare and Medicaid Services (CMS) Benefits Coordination and Recovery Center (BCRC), the Quality Assurance Analyst III helps to ensure high quality performance standards are maintained in the handling of customer service calls and in the processing of correspondence.  This position also performs Recovery Specialist responsibilities upon completion of assigned quality assurances tasks, as well as requires the ability to travel on an as needed basis.

     

    ESSENTIAL DUTIES AND RESPONSIBILITIES

    Essential duties and responsibilities include the following.  Other duties may be assigned.

     

    Responsible for the integration of CNI Core Competencies into daily functions, including: commitment to integrity, knowledge / quality of work, supporting financial goals of the company, initiative / motivation, cooperation / relationships, problem analysis / discretion, accomplishing goals through organization, positive oral / written communication skills, leadership abilities, commitment to Affirmative Action, reliability / dependability, flexibility and ownership / accountability of actions taken.

     

    Reviews the quality of calls handled by the BCRC Call Center staff, as well as correspondence processed by the Recovery Specialists.  Assesses adherence to quality guidelines and Standard Operating Procedures (SOPs).

     

    Evaluates random samples of calls and processed correspondence.  Reports findings to management.

     

    Identifies possible knowledge gaps, training issues and/or error trends.  Reports findings, as directed.  Suggests process improvements to reduce errors and improve quality.  Provides support, monitoring and tracking, as may be required. 

     

    Assists in the preparation of regularly scheduled quality reports for use by upper management.  May be required to report on the status of quality assurance processes.  Compiles, stores, tracks and retrieves data for reports. Ensures efficiency in the reporting process and accuracy of information.  

     

    Assists with Recovery Specialist duties upon completion of assigned QA tasks.  Follows the essential duties and responsibilities of the Recovery Specialist III for correspondence processing.

     

    Maintains a thorough knowledge of BCRC statutes, regulations, computer systems and SOPs, including primary contract operations in functional areas of Medicare Secondary Payer (MSP) calls and correspondence from beneficiaries, attorneys and other insurance companies.  Maintains confidentiality, and upholds standards for privacy, security and data integrity.

     

    Assists other team members, as needed while maintaining the integrity of applicable BCRC SOPs.  Trains coworkers on quality processes, as requested by management.

     

    Quantifies figures for management review upon request. 

     

    Works with other Quality Assurance Analysts and Recovery Specialists to ensure consistency in QA reporting processes and applicable archiving / recordkeeping. 

     

    Determines / documents appropriate guidelines for all quality assurance measurements.

     

    Responsible for aiding in own self-development by being available and receptive to any training made available by the company.

    Plans daily activities within the guidelines of company policy, job description and supervisor's instruction in such a way as to maximize output.

     

    Responsible for keeping own immediate work area in a neat and orderly condition to ensure safety of self and coworkers. Will report any unsafe conditions and/or practices to the appropriate supervisor and Human Resources. Will immediately correct any unsafe conditions as the best of own ability.

     

    EDUCATION / EXPERIENCE

    Bachelor's degree and a minimum of five (5) years relevant quality assurance experience in a customer service center environment, with at least two (2) years’ experience in auditing, bookkeeping, or other applicable area of business; or equivalent combination of education / experience. 

     

    CERTIFICATES / LICENSES / REGISTRATION

    U.S. Citizens / Green Card only due to government or federal requirement

    Microsoft or similar certifications / training preferred

    ISO 9000, Six Sigma or Sarbanes Oxley compliance certifications preferred

     

    JOB SPECIFIC KNOWLEDGE / SKILLS / ABILITIES

    Proficient knowledge and understanding of Medicare and Medicaid Services related to benefits coordination and recovery services

    Operational knowledge and understanding of government documentation standards

    Working knowledge of standard quality assurance practices, such as ISO 9000, Six Sigma, Sarbanes Oxley, etc.

    Knowledge and understanding of data warehousing, analysis, and extraction

    Skilled proficiency with Microsoft Office Suite (i.e., Word, Excel, PowerPoint, Access, etc.) and SQL querying software

    Detail-oriented with exceptional organization, analytical, problem-solving and critical thinking skills

    Excellent verbal and written communications skills with solid presentation and reporting skills

    Excellent customer service skills

    Ability to clearly and concisely communicate / explain information to a broad range of people with varying levels of expertise and/or responsibility

    Ability to determine and document appropriate guidelines for all quality assurance measurements. 

    Ability to construct, document and implement approved procedural changes

    Ability to manage multiple projects and priorities as well as to meet specified deadlines

    Ability to use discretion in the handling of confidential or sensitive information

    Ability to work both independently and in a team environment

    Ability to travel, as required

     

    LANGUAGE SKILLS

    Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.

     

    MATHEMATICAL SKILLS

    Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.

     

    REASONING ABILITY

    Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.  Ability to deal with problems involving several concrete variables in standardized situations.

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