QA Coordinator

MarketSource is a sales acceleration company focused on delivering better outcomes for many of the worlds most iconic brands. We design operationalize and execute managed sales and customer experience solutions for companies in B2B and B2C environments.

Our solutions are purpose-built and tech-enabled to deliver measurable improvements in business outcomes. We live by a set of people-focused values that guide our relationships with each other and with our clients. By putting people first working together to make others successful and establishing a rich and empowered work culture we create opportunities for our people and the businesses we serve to be successful.

Summary

As a Quality Assurance Coordinator servicing health insurance industry clients you will ensure best-in-class quality assurance in a highly regulated environment. Working closely with the Quality Assurance Supervisor this role is responsible for ensuring that agent-member interactions program documentation and processes meet client requirements and compliance standards with respect to applicable regulations (e.g. HIPAA CMS). By evaluating performance against program requirements and compliance standards this position plays a critical role in identifying initiatives related to automation coaching auditing data reporting and training.

More specifically you will monitor agent/customer interactions conduct audits and participate in continuous improvement initiatives to meet or exceed client contractual quality commitments and enhance customer this role you will collaborate with team members across the organization to uphold high performance standards and implement innovative quality solutions.

Essential Job Functions:

• Call Monitoring & Evaluation: Monitor and evaluate inbound and outbound calls to assess compliance service quality accuracy and adherence to scripts and policies. Use standard scorecards to rate communication skills compliance and resolution effectiveness for each interaction.
• Compliance Audits: Conduct regular QA audits of customer service interactions documents and processes to ensure adherence to health insurance regulations and client requirements (e.g. verify HIPAA privacy compliance Medicare/CMS guidelines).
• Feedback & Coaching: Identify constructive feedback and coaching opportunities for call center agents focused on improving customer service skills and compliance. Partner with relevant internal stakeholders to develop refresher training or new learning modules for recurring issues.
• Quality Reporting & Analysis: Analyze QA data and metrics (quality scores error trends customer feedback) to identify trends root causes and areas for improvement. Prepare and present detailed quality reports for Supervisors highlighting performance against KPIs and recommending actions. Ensure all reporting is timely accurate and aligned with client SLAs.
• Customer Service & Continuous Improvement: Champion a customer-centric approach in quality programs ensuring that QA standards align with exceptional customer service and positive member experiences. Promote a culture of continuous improvement and innovation introducing initiatives (e.g. process automation updated QA scorecards new monitoring techniques) that elevate quality and efficiency.
• Contractual & SLA Adherence: Maintain QA schedules (e.g. call sampling rates) and partner with applicable stakeholders to ensure quality targets are met or exceeded.
• Regulatory Compliance Assurance: Stay up-to-date on all relevant health insurance industry regulations and client compliance standards. Ensure quality processes and agent evaluations incorporate checks for regulatory requirements (e.g. proper call disclosures data privacy and security protocols documentation accuracy). Conduct focused compliance monitoring (such as verifying HIPAA procedures on calls) and support any external audits or quality assessments by providing necessary documentation and reports.

Required Knowledge Skills and Abilities:

• Analytical & Reporting Skills: Strong analytical abilities with experience in data analysis and QA metrics interpretation. Proficiency in creating and sharing quality reports presentations and dashboards for stakeholders. Able to identify trends and root causes from data and drive actionable insights for process improvements.
• Communication & Coaching: Excellent verbal and written communication skills. Ability to deliver clear constructive feedback and training to frontline employees to improve performance. Strong interpersonal skills with a collaborative approach to work effectively with agents trainers managers and clients.
• Knowledge of Compliance Standards: In-depth knowledge of health insurance regulations and compliance requirements including HIPAA privacy/security rules and Medicare/Medicaid guidelines for call centers. Demonstrated commitment to maintaining confidentiality and data security in handling Protected Health Information.
• Organizational Skills: Detail-oriented and highly organized with the ability to manage QA review schedules multitask across different client programs and meet strict deadlines for reports and audits. Capable of maintaining documentation and records with a strong attention to detail for auditing purposes.
• Problem-Solving & Improvement Mindset: A proactive mindset focused on continuous improvement and innovation in quality processes. Ability to troubleshoot quality issues facilitate root cause analysis and implement process or policy enhancements that improve service outcomes. Adaptable to change and able to update QA criteria as business needs and industry standards evolve.
• Technical Proficiency: Proficient with standard office software (e.g. MS Excel Word PowerPoint) and experienced in using call center QA monitoring tools. Hands-on experience with quality management systems or call recording software is preferred. Comfortable working with Customer Relationship Management (CRM) systems and contact center telephony platforms; able to quickly learn new software and analytics tools related to quality monitoring.

Job Requirements:

• High school diploma or GED required.
• Experience: 2 years of experience in call center quality assurance with prior QA experience in the health insurance or healthcare industry strongly preferred. Familiarity with health insurance products terminology and member services processes is essential. Experience in a BPO/outsourcing environment or high-volume contact center is highly valued.
• Compliance Training:HIPAA compliance certification or formal trainingin privacy and security of healthcare information isstrongly preferred. Anyadditionalcertifications in healthcare compliance or call center compliance (e.g. CMS training) would be beneficial.
• QA/Customer Service Certifications:Certifications in call center quality or customer service (for example COPC or other contact center excellence certifications) are an advantage as theydemonstrateknowledge ofindustry best practices in quality assurance and customer experience.
• Quality Monitoring Software:Proficiencywith call recording andquality management systems for evaluating interactions and tracking QA data. Experienceleveragingthese tools to create scorecards record evaluations and generate QA reports.
• Contact Center Technologies:Working knowledge ofcall center telephony systems CRM software and workforce management tools. Ability to navigate systems commonly used in health insurance BPO operations to verify information during QA reviews.
• E-Learning/Training Tools:Experience with e-learning platforms or Learning Management Systems (LMS) is a plus to coordinate agent training and track the effectiveness of coaching interventions related to quality improvement.

MarketSource is an Equal Opportunity Employer and will consider all applications without regards to race sex age color religion national origin veteran status disability sexual orientation gender identity genetic information or any characteristic protected by law. If you would like to request reasonable accommodation such as the modification or adjustment of the job application process or interviewing process due to a disability please call or email

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections plan or program terms. This role may be eligible for the following:

• Medical dental & vision
• 401(k)/Roth
• Insurance (Basic/Supplemental Life & AD&D)
• Short and long-term disability
• Health & Dependent Care Spending Accounts (HSA & DCFSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO Vacation or Sick Leave)

San Fran Candidates only: Pursuant to the San Francisco Fair Chance Ordinance we will consider for employment qualified applicants with arrest and conviction records.

Los Angeles Candidates only: We will consider for employment all qualified applicants including those with criminal histories in a manner consistent with the requirements of applicable state and local laws including the City of Los Angeles Fair Chance Initiative for Hiring Ordinance.

Unincorporated Los Angeles County Candidates Only: Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. Where applicable in accordance with the Los Angeles County Fair Chance Ordinance for Employers Candidates must satisfy all pre-employment screening criteria and may be disqualified due to criminal history because the requirements of this position as outlined above may include: access to valuable company assets; exercise of good judgment and performance of duties safely under work conditions that may be stressful including under supervision of client; access to sensitive personal or financial information; and/or access to objects that may be used to inflict injury or harm to others.