Audit recorded or live transactions (voice calls and digital interactions) to evaluate agent performance based on established quality metrics.
Ensure 100% adherence to HIPAA (Health Insurance Portability and Accountability Act) and PHI (Protected Health Information) guidelines to protect patient privacy.
Provide constructive feedback and coaching sessions to agents to help them improve their communication skills, medical terminology accuracy, and overall performance.
Participate in regular quality calibration sessions with Team Leaders and Operations Managers to ensure consistent scoring standards.
Track quality trends, identify recurring errors, and prepare weekly/monthly quality reports for management.
Job Requirements
At least 12 years of experience as an agent or QA in a BPO setting, preferably handling a Healthcare or Medical insurance account.
Strong familiarity with healthcare customer service standards, medical billing/claims terminology, and HIPAA compliance.
Exceptional listening, analytical, and communication skills. Strong attention to detail is a must
