QC Specialist Operations

Renaissance Life & Health Insurance Company of America; Indianapolis (IN); Hybrid; USD 60,000 - 75,000; Full time

Job summary

Renaissance Benefits in Indianapolis, IN, is seeking a QC Specialist, Operations to identify, analyze, and recommend process improvements that raise quality and efficiency.

You will audit claims processing, group implementations, eligibility, and data entry, and you will compile and analyze data to ensure compliance with standards.

Collaborate with trainers, supervisors, and management on trends from the quality monitoring process, develop action plans, and maintain related documents.

Qualifications

• Associate degree required with 3 years in a claims processing environment.
• Knowledge of dental terminology, procedures, and insurance products.
• Strong verbal and written communication and organizational skills.

Responsibilities

• Audits claims processing, group implementations, eligibility, and data entry; compiles analytics to support quality standards.
• Identifies and analyzes process improvements to boost efficiency and quality; assists with inventory reports.
• Partners with trainers, supervisors, and management on trends from quality monitoring to address issues requiring coaching.
• Develops and controls quality control programs and action plans; maintains related documentation.
• Recognizes development needs and assists with training programs.
• Verifies that department documentation is current and aligns with quality guidelines.

Skills

Process improvement

Data analysis

Audit QC

Data reporting

Communication

Collaboration

Education

Associate degree

Tools

Word processing

Spreadsheets

Job description

Job Title:

QC Specialist Operations

Number of Positions:

1

Location:

Indianapolis, IN

Location Specifics:

Hybrid Position

Job Summary:

Renaissance Benefits is hiring for a QC Specialist, Operations!

At Renaissance, the QC Specialist, Operations identifies, analyzes, and recommends process improvements that will result in increased quality and efficiency.

• Audits claims processing, group implementations, eligibility, and various data entry functions and compiles and analyzes data to determine compliance with quality, production, and performance standards. Develops, prepares, maintains, and distributes reports for productivity and quality control.
• Identifies, analyzes, and recommends process and/or operational improvements to enhance efficiency, quality, and operational effectiveness. Assists management staff with report of inventory.
• Partners with trainer, supervisors, and management on trends identified through the quality monitoring process including customer service issues, processing, and data errors that require coaching and advanced training of staff.
• Recommends, develops, and controls quality control production, programs and procedures and initiates and facilitates the development of action plans to address deficiencies identified in the audit process, as well as monitor and maintain the related documents.
• Recognizes and communicates development needs of employees and assists with training programs.
• Verifies that department documentation is current and supports quality guidelines.

Minimum Requirements:

• Position requires an associate’s degree, technical, vocational, or business school with coursework in business administration and three years’ work experience in a claims processing environment. Will accept any suitable combination of education, training, or experience.
• Position requires knowledge of dental terminology, procedures, insurance products, and claims processing; advanced knowledge of word processing and spreadsheets; ability to identify weaknesses in process changes that may affect quality; resolves complex problems and uses latitude for independent judgment; effective verbal and written communication skills and organizational skills; ability to collaborate effectively; ability to handle multiple projects and deadlines; recommends improvements to increase quality and efficiency.

The company will provide equal employment and advancement opportunity within the context of its unique business environment without regard to race, color, religion, gender, gender identity, gender expression, age, national origin, familial status, citizenship, genetic information, disability, sex, sexual orientation, marital status, pregnancy, height, weight, military status, or any other status protected under federal, state, or local law or ordinance.