QC Specialist Operations

Renaissance Life & Health Ins Co of Am; Indianapolis (IN); Hybrid; USD 55,000 - 70,000; Full time

Job summary

Renaissance Benefits is seeking a QC Specialist, Operations to audit claims processing, eligibility, and data entry while developing reports to drive quality and efficiency. The role supports management with trends, coaching, and training needs, and works with a cross-functional team to implement effective process changes.

Ideal candidates have an associate degree with three years in a claims environment, strong word processing and spreadsheet skills, and the ability to communicate clearly and

Qualifications

• Verbal and written communication skills are required.
• Ability to collaborate effectively with teams is essential.
• Must manage multiple projects and deadlines.

Responsibilities

• Audit claims processing, group implementations, and eligibility.
• Analyze data and prepare reports to support quality and productivity.
• Identify and recommend process improvements and best practices.
• Support management with monitoring and coaching based on audit findings.
• Maintain and update quality documentation and procedures.

Skills

Verbal communication

Written communication

Collaboration

Multitasking

Organizational skills

Education

Associate degree or equivalent

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.

EEO and Diversity Statement

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.

Benefits

Renaissance Life & Health Insurance Company of America and its sister company Renaissance Life & Health Insurance Company of New York, offer supplemental health and ancillary benefits for employer groups and individuals nationwide. RenSecureHealth, a modern supplemental health offering, as well as dental, vision, life and disability insurance comprise the core line of the company’s ancillary benefits solutions.

Additional Information

With headquarters in Indianapolis, Indiana, Renaissance is focused on providing its members and partners with outstanding products and services. Visit www.renaissancebenefits.com and find us on Facebook, LinkedIn and Twitter.