Customer Service Quality Assurance Specialist

20 Driscoll Children's Health Plan; Corpus Christi (TX); On-site; USD 42,000 - 60,000; Full time

Job summary

Driscoll Health System is seeking a Quality Assurance Specialist to monitor healthcare calls for members and providers, develop process improvements, and support the Customer Service Supervisor with coaching CSRs.

The role emphasizes call quality, data analysis, and training support, including calibration sessions and regular reporting to management to maintain high service standards across the organization.

Qualifications

• High School diploma or two years of progressive call center experience.
• Excellent communication to handle complex customer needs.
• Strong knowledge of Microsoft Office applications (Word, Excel, PowerPoint, Outlook).

Responsibilities

• Monitor inbound and outbound calls to ensure quality and policy adherence.
• Provide coaching recommendations based on monitor findings and performance data.
• Prepare calibration reports and participate in training sessions.
• Assist in management reporting and cross-team communications.
• Complete 4 hours of phone time monthly.

Skills

Outstanding communication

Analytical skills

MS Office suite

Education

High School diploma

Tools

Microsoft Office Suite

Job description

Where compassion meets innovation and technology and our employees are family. Thank you for your interest in joining our team! Please review the job information below.

GENERAL PURPOSE OF JOB

The Quality Assurance Specialist is responsible for monitoring inbound/outbound healthcare calls for Member/Provider. Develop process improvements; analyze performance with the use of resources, and to identify concerns for/by Member/Provider to ensure a first call resolution. The Quality Assurance Specialist will also assist the Customer Service Supervisor by providing direct coaching and feedback to the Customer Service Representatives (CSRs).

ESSENTIAL DUTIES AND RESPONSIBILITIES

To perform this job 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. This job description is not intended to be all-inclusive; employees will perform other reasonably related business duties as assigned by the immediate supervisor and/or health plan administration, as required.

• General Duties:
• Screens incoming and outgoing calls to ensure quality, customer service, and adherence to the policies and procedures of the organization.
• Complete designated number of documented monitors of customer contacts.
• Utilize approved monitoring tools and standards to assess the representatives’ knowledge of products, business practices and systems.
• Convert monitor findings and scores into coaching recommendations for performance improvement actions to internal/external parties.
• Facilitate scheduled calibration sessions that foster a consistent and reliable assessment of representative’s skills and behaviors by internal/external parties.
• Generate calibration recap reports for each scheduled calibration session.
• Participate in user acceptance testing exercises as needed for new product releases.
• Prepare reports as needed for the management team.
• Participate as needed in conference calls and meetings.
• Will be required to complete 4 hours of phone time monthly.
• Exceptional listening, analytical, and communication skills (written and oral).
• Researches and formulates solutions in conjunction with leadership related to call center representative performance.
• Ability to identify issues, to obtain relevant information, relate and compare data from different sources, and identify alternative solutions.
• Ability to accomplish tasks accurately and completely.
• Ability to take action to achieve goals beyond what is required; ability to be proactive.
• Ability to develop plans to accomplish tasks and objectives, work using resources efficiently, to follow instructions through a standard work process, and to monitor or regulate those procedures, tasks, or activities.
• Perform other assigned duties as needed.
• Training Responsibilities
• Participate and support refresher training as needed on quality monitoring methods, tools, facilitation skills, and product features.
• From call monitor data, identify opportunities to improve training content.

EDUCATION AND/OR EXPERIENCE

• Minimum of a High School diploma; or a minimum of two year’s progressive experience in a call center or equivalent combination of education and experience.
• Outstanding communication skills and the ability to understand complex situations to effectively handle customer needs.
• Strong knowledge of Microsoft Office, including Word, Excel, PowerPoint and Outlook.
• Knowledge of commonly‑used concepts, practices, and procedures within the call center.

Until all children are well. Driscoll Children’s Hospital and its specialty centers, urgent care centers, and after-hours facility serve a vast area covering 31 South Texas counties. The hospital is a 191‑bed tertiary care center offering 32 medical and 13 surgical specialties. Combined with our non-profit, community-based Health Plan, Driscoll Health System is an exceptional workplace for anyone with a big heart and a drive for success. Smiles, hugs and a soothing touch are as much a part of Driscoll’s approach to treating children as is its advanced medical treatments and technologies. The core values at Driscoll Heath System are: Compassion, Advocacy, Respect, Excellence, and Stewardship. These values are exemplified through every position - from treating the most critical patients hands‑on, to maintaining a clean environment, to keeping the organization running from behind the scenes. We invite you to learn about Driscoll’s rich history and explore the laidback lifestyle South Texas has to offer.