Quality Audit Specialist

Quality Audit Analyst

Fully remote. This position is part of the AEP hiring team. The pay rate is ***/hour.

Summary:

Completes day-to-day Quality Review and Audit tasks of Telesales Agents that align to CMS rules and regulations when interacting with a Medicare beneficiary. May assist in more complex audits when necessary. Tasks involve a high degree of time management, forward planning and anticipation of needs/issues.

Responsibilities:

• Perform "live" call monitoring of Telesales Agents to ensure CMS compliance guidelines are achieved
• Review and evaluate recorded call interactions between internal agent and customer
• Maintain reporting metrics as a tracking resource
• Provide feedback to Supervisors and Managers regarding Agent performance and compliance adherence
• Provides support locating call recordings to departments within Medicare Growth organization
• Performs additional audit assignments as directed by Direct-to-Consumer Leadership
• Provides training as needed to Agents regarding telephonic evaluations
• Ensures that Direct-to-Consumer agents adhere to CMS filed telephonic scripts and agent workflows
• Collaborate with peers to ensure consistency in Agent workflows and processes
• Track and trend monitoring results to identify risks/determine areas of improvement
• Drives strong quality audit results; resolves sources of audit issues and translates to effective training, coaching, mentoring and process improvement

Qualifications:

High School Diploma and 3 or more years work related experience required, Bachelor's Degree highly preferred. Experience working in a Telesales environment during the CMS Annual Enrollment Period. Knowledge of CMS compliance policies and procedures preferred. High attention to detail, quality and accuracy required. Strong coordination and organizational skills and ability to communicate effectively and follow-up where needed. Fast-learner and multi-tasking skills. Ability to work independently and within a team environment in a matrixed environment required. Strong interpersonal and prioritization skills preferred. Sales and/or training experience recommended. Excellent listening, written and verbal communication skills required. Adaptability, flexibility, and ability to manage through change in a fast-paced environment required.

Requirements:

Health and Accident Insurance License. Must be available to work a flexible schedule that may include weekends and the day after Thanksgiving. AHIP/Medicare Certification. Internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

EEO: "Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans."