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Performance Quality Analyst I
Elevance Health. Drive service quality excellence by evaluating the quality of enterprise services and interactions .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in evaluating service quality, conducting audits, and analyzing data within the healthcare or insurance sector. Proficient in enrollment and billing processes, claims processing, and customer service interactions.
Highest-signal resume keywords
Enrollment And Billing ExperienceClaims Processing ExpertiseAudit Policy ApplicationData Analysis And InterpretationHealthcare Or Insurance Sector Experience
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Audit DocumentationRisk AssessmentQuality EvaluationCorrective Action PlanningData Analysis
Soft Skills
Communication SkillsProblem-Solving Skills
Industry Keywords
HealthcareInsuranceCustomer ServiceAutomated EnvironmentField Work
About the role
Key responsibilities & impact- Drive service quality excellence by evaluating the quality of enterprise services and interactions
- Evaluate enrollment and billing, claims processing, and customer service written and verbal inquiries
- Assist higher-level auditors/leads with assigned field work
- Perform special and targeted audits requested by internal management
- Participate in pre- and post-implementation audits of providers, claims processing and payment, benefit coding, member and provider inquiries, enrollment and billing transactions, and corrective action plans
- Analyze and interpret data and make recommendations for change
- Apply audit policy and assess risks to minimize exposure and mitigate risks
- Document audit results and findings
- Suggest appropriate remediation
Requirements
What you’ll need- Requires a BS/BA
- 2+ years related experience in an enrollment and billing, claims and/or customer contact automated environment
- Preferably experience in the healthcare or insurance sector
- Equivalent combination of education and experience may be accepted
- Must work in-office 1–2 days per week
- Must reside within commuting distance from an Elevance Health office, unless an alternate location is approved
Benefits
Comp & perks- Merit increases
- Paid holidays
- Paid Time Off
- Incentive bonus programs
- Medical benefits
- Dental benefits
- Vision benefits
- Short-term disability benefits
- Long-term disability benefits
- 401(k) with company match
- Stock purchase plan
- Life insurance
- Wellness programs
- Financial education resources
- Hybrid work arrangement with virtual-work flexibility