Randstad Jr Quality Analyst in Boston, Massachusetts
Jr Quality Analyst
Wednesday, September 28, 2016
Randstad Finance & Accounting
Administers Quality Assurance (QA) program for defined product or customer that is consistent with department metrics.
Conduct quality audits of claims. Quality audit may be focused one or all aspects of claim from notification to closure.
Determine compliance with claims handling standards, policies and procedures.
Works closely with claims line managers to report QA results to claims staff (for defined product or customer).
Identifies trends and makes recommendations for changes to process, procedures and training in accordance with findings.
Tracks compliance with changes and/or corrections needed as a result of audit findings.
Continuously improves the QA process for defined product or customer to ensure consistently rigorous claim management decisions, accuracy, and customer service.
Assist field Operations Manager and other QA staff with roll-up of results; draws conclusions and makes recommendations based in accordance with findings.
Analyzes claim reports to identify trends, problems, and effectiveness with defined product or customer. Monitors field office desk-audits and ensure action plans are addressing applicable trends.
Bachelor s degree or equivalent experience preferred. Minimum of 2 years disability claims management experience and knowledge of disability claims payment systems preferred. Knowledge of Claims coverage and case management procedures required. Analytical skills, interpersonal skills, and strong written and oral communication skills required. Ability to work independently or as part of a group. Strong overall knowledge of Group Market departments and processes preferred.