**Resp & Qualifications**

**PURPOSE:**
The Quality Specialist II is responsible for examining and evaluating the accuracy of transactions in accordance with regulations, and company guidelines. Fairly and consistently reviews team interactions with both internal and external parties to ensure accuracy and support success in executing superior service and quality. Acts as subject matter expert and actively participates in projects.

**ESSENTIAL FUNCTIONS:**

+ Audits assigned function claims for accuracy, benefit payment, contract interpretation, and compliance with policies and procedures. Identifies, documents and reports transaction errors utilizing departmental quality monitoring templates in a timely manner to ensure prompt resolution.
+ Conducts structured coaching and feedback sessions. Provides feedback and recommends improvement action plans for areas of deficiency within the group or for an individual.
+ Participates in the creation and imple...