What are the responsibilities and job description for the Field Service Auditor position at HealthFirst?
The incumbent will investigate, audit, conduct root cause analysis, handle processing of determinations, track and trend findings. The individual at this level will embody Healthfirst’s Culture Drivers through his/her workplace behavior and works under minimal supervision.
- Monitor Field Service Agents during encounter with members to determine quality standards are being met including improvement of the overall member experience.
- Record/track quality assessment scores and provide feedback to reduce errors and improve processes and performance.
- Exercise discretion and objective judgement to ensure agents are appropriately identifying, researching, and resolving customer issues using appropriate methods and tools while effectively managing face to face encounters.
- Present results of investigations and error trends to leadership staff through written reports, dashboards, etc.
- Identify defects and improve departmental performance by supporting quality, operational efficiency, and production goals.
- Meet established time frames and rates of performance for the quality and quantity of work for the position.
- Assist in the development of departmental policies and procedures; review the effectiveness of existing training.
- Work a flexible schedule, nights, weekends, and/or holidays with limited notice.
- Travel is required to multiple sites.
Minimum Qualifications:
- Experience working as a Field Service or Call Center Agent
- Must be fluent in Cantonese/Mandarin
- Ability to multi-task, prioritize, and manage time effectively.
- Communicate effectively verbally and in writing while demonstrating good grammar, spelling and punctuation skills.
- Strong active listening skills
- Experience in Microsoft Office suite of applications including Excel (formatting formulas, managing data, and filtering results), Word (creating and editing documents), PowerPoint (creating and editing presentations).
- Driver’s License and ability to travel to multiple sites
- High School Diploma or GED from an accredited institution
Preferred Qualifications:
- Associate degree from an accredited institution.
- Conflict resolution experience
- Knowledge of at least two or more lines of business such as Medicare NY/NJ, Medicaid, Family Health Plus, Child Health Plus, NH Family
- Experience in an Auditing capacity conducting root cause analysis
- Experience working with confidential information
Please note: Since we care so greatly about our employees' and members' wellbeing, Healthfirst is moving to an environment where our employees are fully vaccinated against COVID-19. As a prospective new team member, you must be fully vaccinated with a CDC/FDA approved COVID-19 shot(s) to work in our offices. If you are selected to interview for this role, we will explain our vaccination policy in further detail and ensure you are comfortable moving forward with this company policy.
WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.
If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with Healthfirst Management Services.
EEO Law Poster and Supplement
All hiring and recruitment at Healthfirst is transacted with a valid “@healthfirst.org” email address only or from a recruitment firm representing our Company. Any recruitment firm representing Healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring about. If you receive a communication from a sender whose domain is not @healthfirst.org, or not one of our recruitment partners, please be aware that those communications are not coming from or authorized by Healthfirst. Healthfirst will never ask you for money during the recruitment or onboarding process.
