Quality Assurance Analyst I

Network Health WI • Menasha, WI

7d • Hybrid

About The Position

The Quality Assurance Analyst I is responsible for identifying quality
inefficiencies within the Member Experience call center by monitoring
organizational processes, promoting service excellence, and ensuring compliance
with quality and operational standards. Key responsibilities include reviewing
calls, claims, and other monitoring activities across multiple lines of
business. This role conducts weekly and monthly evaluations, reports findings,
and supports the development, implementation, and ongoing assessment of quality
assurance policies and procedures.

Additionally, the analyst partners with cross-functional teams to enhance
monitoring practices, strengthen compliance, and drive continuous operational
improvement.

Requirements

• Associates degree or equivalent work experience required
• 3 or more years of experience working in healthcare or health insurance.
• One or more years of experience working in one or more of the following: claims, customer service, billing/coding, appeals and grievances or another data entry related position required.

Nice To Haves

• Bachelor’s degree preferred

Responsibilities

• Performs data entry, claim, and call monitoring activities and scores performance according to set criteria and timelines
• Perform other operational audits and scores performance according to set criteria and timelines.
• Trends monitoring results and provides feedback to the Manager of Quality Assurance
• Compiles results into meaningful, actionable reports with recommendations for process improvements
• Documents findings and makes recommendations for efficiencies based on monitoring results
• Responsible for accurate and timely performance of monitoring activities
• Maintains and updates tracking databases and/or files to support monitoring activities
• Ensures quality assurance process documentation remains up to date
• Other duties as assigned

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree