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Quality Assurance Specialist

Genex Services Boca Raton Full-Time
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The Quality Assurance Specialist is responsible for ensuring processes, adherence to compliance processes and protocols, coordination of activities so that customer service and satisfaction is ensured and that regulatory compliance requirements are met.

Main Responsibilities will include but are not limited to:

  • Deliver quality Customer Service from initial request for service until completion of end product
  • Ensure the quality and completeness of end product

•         Identify and isolate errors – communicating with Supervisor of Operations and Compliance Officer with regard to any jurisdictional changes

  • Liaise with clients where necessary (when impacted/affected by quality issues)
  • Serve as subject matter expert with regard to client protocols pertaining to end product

•         Ensure turnaround time on reports meets with organizational standards as well as client protocols

  • Ensure end-product complies with jurisdictional regulations

•         When needed, work with client to provide a resolution to concerns regarding the end product

  • Communicate immediately with Supervisor of Operations with regard to any client concerns
  • Has a clear and concise understanding, and adheres to, guidelines as they relate to HIPAA, Conflict of Interest , and Ethics

•         Understand current URAC standards as appropriate to job functions

•         Other duties as assigned

Qualifications:

  • HS Diploma or equivalent
  • Relevant industry related experience (IME/Peer Reviews, Legal, Claims experience)

•         Remote employees in this position will be expected to ensure the protection of proprietary Company and customer information accessible from their home or satellite office.  Steps include, but are not limited to, use of locked file cabinets, disk boxes and desks, regular password maintenance, and any other steps appropriate for the job and the environment

•         LPN/RN Degree a plus - Where applicable, employee must notify the Quality Manager immediately of any changes in professional active license status for any state license is being utilized for current position or current certifications status

  • Proficient with MS Office Suite
  • Excellent communication skills-verbal and written
  • Ability to organize and prioritize work effectively
  • Ability to accept and apply constructive feedback

Genex is an equal opportunity, at-will employer and does not discriminate against any employee or applicant for employment because of age, race, religion, color, disability, sex, sexual orientation or national origin.
 

Skills required

Sample Procedure
Quality Assurance
Performance Testing
Perform Inspection
Total Quality Management
Provide Technical Guidance
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Job ID: 1218

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GENEX Services, LLC. is one of the nation’s leading providers of disability management and medical cost containment services in the occupational, non-occupational, auto and group healthcare markets. GENEX clients include self-insured employers, insurance carriers, managed care organizations, and third party administrators. Services are provided to over 1200 clients throughout 120 locations in all 50 states, Puerto Rico and Canada. Headquartered in Wayne, PA (15 miles outside of Philadelphia), and with more than 2400 employees and 120 locations throughout the US, Puerto Rico & Canada,

GENEX provides services to self-insured employers, insurance carriers, managed care organizations, and third party administrators. OUR MISSION is to provide exceptional healthcare and disability management solutions to our customers, to be a strategically important business partner, and through our competitive spirit and unsurpassed delivery of innovative services, to create a brighter future for those we serve.

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