Insurance Quality Assurance Specialist

About the job
Roles based outside of our Denver office can sit in any of the following 36 states AL, AZ, AR, CA, CO, FL, GA, IL, IN, IA, KS, KY, LA, MA, MD, MI, MN, MO, MS, NE, NC, NJ, NV, NM, NY, OH, OK, PA, SC, TN, TX, UT, VA, WA, WV, and WI. Please only apply if you are able to live and work full-time in one of the states listed above.
About the role:
As an Insurance Quality Assurance Specialist, the primary focus of this position is to work alongside our QA team to drive performance across internal teams to positively impact key customer indicators. This is an exciting opportunity for a self-motivated, curious person who enjoys digging into data to solve problems collaboratively across different teams and has a knack for spotting trends.
As the Insurance Quality Assurance Specialist, you will support cross-functional teams in reporting on trends to help them see opportunities for improvement, provide root cause investigation to stakeholders on issues affecting team performance, work with individuals to find ways to exceed targets, and support a variety of projects associated with QA team goals. You will work on problems and projects that seek to answer core business questions where you will look to a myriad of tools/resources to find your answer. You will drive improvements and enhancements to our data, processes, our tools, and our product. You will be a problem solver who uses data to drive decisions, pays extreme attention to detail, and is able to communicate to diverse groups of individuals to deliver complex data in easily digestible language.
Responsibilities include:

• Leads a team of QC Coordinators to ensure daily and weekly sample plans are both assigned and completed per sampling plan guidelines
• Categorize and report on trends while continuing to look for additional opportunities for process improvement
• Root cause understanding on large issues that affects team performance and ability to find ways to hit or exceed targets
• Coordinates and delivers training in coordination with Operations
• Support projects aligned with Company Goals
• Calibration with other QA Coordinators/Specialists on a bi-weekly basis to ensure methods are not disparate
• Reviewing and interrogating NPS via Practice Surveys, CSAT surveys, or other key repositories to provide insight to causes and potential opportunity areas
• Review and document business process continuous improvement opportunities
• Drive enhancements for reporting, QA methodology and potential system enhancements

Skill Set:

• 1 - 3 years of experience in quality assurance or data analysis
• 3+ years of Healthcare Industry experience; specifically in insurance
• Bachelor's degree preferred
• Understanding of statistical, trend, and performance analysis
• Fundamental understanding of tools, methods, and concepts of quality assurance - especially best practices
• Knowledge of key indicators like NPS, how it affects business performance, and how QA can help the business increase NPS
• Project management concepts and a general understanding of OKRs/KPIs as success metrics
• Ability to simplify data into insights
• Ability to articulate the business case for enhancements
• Proficient in Microsoft Excel or Google Sheets
• Minimum of 1 year of data analytical tools example: SQL, Tableau, PowerBI, etc.

What's in it for you...

• Full medical, dental, and vision benefits with 100% employer-paid options
• 401(k) match
• A supportive culture with one-of-a-kind growth and development opportunities
• Option to work from home or in the office
• Unlimited PTO
• Employer HSA contribution
• Paid Parental Leave
• Company and team outings
• Peer-to-peer recognition program
• Company sponsored premium subscription to the Calm app
• Vendor discounts

Compensation: $50,000K/annually
Work Authorization: You must be authorized to work for any employer in the US.
**Please note that the above compensation information is a good faith estimate for Colorado-based hires only and is provided pursuant to the Colorado Equal Pay for Equal Work Act and Equal Pay Transparency Rules.**
Who We Are
OrthoFi is an experienced, tech-enabled solution that helps Orthodontists start more patients and give them more time to provide great quality care. With the acquisition of OrthoBanc in 2020, OrthoFi is now the US orthodontic industry expert in practice financial management, working with over 2,000 practices in the US. Collectively with OrthoBanc, OrthoFi has helped over 3.2 million patients access quality, affordable Orthodontic care. Our combination of the latest Patient Acquisition software and Revenue Cycle Management solutions helps practices grow by over 13% year-over-year and manages patient and insurance billing and collections with collection results that exceed industry standards. We have about 400 employees, with offices in Denver CO and Chattanooga TN.
Our purpose is to radically improve the way patients access and pay for quality elective care. Diversity, equity, and inclusion (DEI) ensures we can fulfill our purpose by creating a better, more equitable and inclusive workplace for our community members and healthcare experience for all.
By focusing on DEI, we are working towards our mission of connecting more patients with quality orthodontic and dental care and helping make treatment accessible to over 1 million patients a year by 2025 . Equity is core to our mission to serve patients, and DEI is embedded in our core values, especially "seek diversity," and "do what's right.""
OrthoFi is proud to be an equal opportunity workplace and is an affirmative action employer. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or Veteran status.
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Top skills for this role
Build these skills listed on the job description or by the job poster.
Analytical Skills
Microsoft Excel
SQL
Data Analysis
Problem Solving
Net Promoter Score
Business Case Preparation
Project Management
Google Sheets
Quality Assurance
Employer-provided
Pay range in United States
Exact compensation may vary based on skills, experience and location
Base pay range
$50,000.00/yr
Featured benefits
Employer-provided
Medical insurance, dental insurance, vision insurance, 401(k), paid maternity leave, and paid paternity leave