Membership Quality Assurance

This position is responsible for performing quality assurance for production areas and within the quality teams of Membership. Delivering feedback to representatives and leadership staff for appropriate coaching actions. Assisting in evaluation of department policies and procedures and being available to communicate, and assist others, with problem solving, coaching, and process improvements.

“This position is eligible to work onsite, remote, or hybrid (9 or more days a month onsite) in accordance with our Telecommuting Policy. Applicants must reside in Kansas or Missouri or be willing to relocate as a condition of employment.”

Why Join Us?

• Family Comes First: Total rewards package that promotes the idea of family first for all employees; including paid time off and family first leave.
• Professional Growth Opportunities: Advance your career with ongoing training and development programs both through our internal Blue University and external opportunities.
• Dynamic Work Environment: Collaborate with a team of passionate and driven individuals.
• Make a Positive Impact: Your work will directly contribute to the health and well-being of Kansans.
• Stability: 80 years of commitment, compassion, and community
• Lead and Inspire: Guide and mentor your team to achieve their full potential and success.
• Balance: paid vacation and sick leave with paid maternity and paternity available immediately upon hire
• Real World Experience: You will work hand in hand with our team in learning our business and applying your classroom learning.
• Networking Opportunities: Participate in our corporate intern program and network with other interns at BCBSKS to enhance your learning opportunity.

Compensation

$23.00- 27.30
Non-Exempt Grade 12

• Blue Cross and Blue Shield of Kansas offers excellent competitive compensation with the goal of retaining and growing talented team members. The compensation range for this role is a good faith estimate, it is estimated based on what a successful candidate might be paid. All offers presented to candidates are carefully reviewed to ensure fair, equitable pay by offering competitive wages that align with the individual's skills, education, experience, and training. The range may vary above or below the stated amounts.

• Responsible for identifying areas of weakness where additional training may be needed and for communicating this information to supervisor/assistant supervisor.
• Responsible for meeting turnaround times that ensure staff can achieve individual, departmental, and corporate goals (to include MTM targets), and to ensure areas of weakness are identified and addressed at the earliest possible time.
• Assists with feedback to supervision on the types of errors made. Makes suggestions on procedure clarifications and on tools or resources to improve accuracy levels.
• Enters employee accuracy data into the Membership Accuracy data base so reports can be used for performance evaluations and reporting accuracy levels for the unit and department.
• Meets regularly with other staff and supervisors to ensure consistency and to share ideas for improvement.
• Must be able to serve on cross departmental or cross divisional teams / meetings as needed for supervision regarding quality additional education, and coaching.
• Responsible for monitoring the status of work items being checked to ensure necessary corrections are complete.
• Answer questions on corporate policies, membership procedures, and state and federal laws as applicable to Membership for BCBSKS staff.
• Must comply with corporate information security policies, standards, and guidelines relative to access control.
• Performs job related projects as assigned by management..

• Knowledge of Membership systems and ability to perform reviews and inspect new and existing contracts, groups, member and group level maintenance, benefit coding, membership finance transactions, customer service packages, and other items within the membership workflow to determine if correct action was taken. Analysis is performed across all lines of business.
• Ability to critically think about and analyze Membership policies, procedures, and processes.
• Ability to identify quality control issues on new or changing products, systems, government laws, mandates, and policies at the individual, unit, and department level to improve accuracy of the department and service to customers.
• Responsible for daily reporting accuracy and completion.
• Responsible for participating and possibly leading meetings and other events as it pertains to the quality assurance goals set by the company.
• Ability to communicate with supervision when additional reference materials are needed.
• Ability to maintain productivity standards as outlined, adhere to corporate compliance program and complete annual required trainings, while maintaining confidentiality.
• Ability to show regular and predictable attendance as defined by policy.
• Must maintain a positive attitude and outlook (independently and as an integral part of a team) including times of environmental change and increased workloads while maintaining a positive attitude and outlook.
• Must be able to frequently use judgement to interpret policies and procedures, critical thinking skills, situation appraisal, and problem solving.

• High school graduate or equivalent required. Additional education in business, communications, or related field is preferred.
• Six months Membership experience or one-year experience in quality assurance or equivalent related work is required.
• Experience using Microsoft programs preferred.
• Experience with reporting and analyzing data preferred.

• Ability to work on a PC for up to 90% of the day.
• In person attendance may be required when requested by leadership.

• Base pay is only one component of your competitive Total Rewards package:
  • Incentive pay program (EPIP)
  • Health/Vision/Dental insurance
  • 6 weeks paid parental leave for new mothers and fathers
  • Fertility/Adoption assistance
  • 2 weeks paid caregiver leave
  • 5% 401(k) plan matching
  • Tuition reimbursement
  • Health & fitness benefits, discounts and resources