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Quality Audit Specialist

Tailored Management

Nashville, TN(remote)

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JOB DETAILS
SALARY
$27 Per Hour
SKILLS
Auditing, Broadband, Call Monitoring, Centers for Medicare and Medicaid Services (CMS), Change Management, Coaching, Communication Skills, Content Management Systems (CMS), Detail Oriented, Establish Priorities, Fiber Optic Cable, Health Insurance, High School Diploma, Internet Service Providers, Interpersonal Skills, Leadership, Maintain Compliance, Medicare, Mentoring, Metrics, Multitasking, Onboarding, Organizational Skills, Presentation/Verbal Skills, Process Improvement, Regulations, Risk Analysis, Sales, Scripting (Scripting Languages), Telesales, Time Management, Training/Teaching, Writing Skills
LOCATION
Nashville, TN(remote)
POSTED
1 day ago
Quality Audit Specialist
Location: Fully remote
Contract duration: 4 months (opportunity for extension or conversion to FTE, depending on performance, attendance, and business needs).
Schedule: Monday – Friday, Standard business hours
Target Start Date: 08/31/2026, pending completion of new hire onboarding
Pay Rate: $27/hr (Paid weekly)

SUMMARY:
  • Completes day-to-day Quality Review and Audit tasks of Telesales Agents that align to CMS rules and regulations when interacting with a Medicare beneficiary. May assist in more complex audits when necessary. Tasks involve a high degree of time management, forward planning and anticipation of needs/issues.
  •  
  • RESPONSIBILITIES
  • Perform "live” call monitoring of Telesales Agents to ensure CMS compliance guidelines are achieved
  • Review and evaluate recorded call interactions between internal agent and customer
  • Maintain reporting metrics as a tracking resource
  • Provide feedback to Supervisors and Managers regarding Agent performance and compliance adherence
  • Provides support locating calls recordings to departments within Medicare Growth organization
  • Performs additional audit assignments as directed by Direct-to-Consumer Leadership
  • Provides training as needed to Agents regarding telephonic evaluations
  • Ensures that Direct-to-Consumer agents adhere to CMS filed telephonic scripts and agent workflows
  • Collaborate with peers to ensure consistency in Agent workflows and processes
  • Track and trend monitoring results to identify risks/determine areas of improvement
  • Drives strong quality audit results; resolves sources of audit issues and translates to effective training, coaching, mentoring and process improvement.

QUALIFICATIONS
  • High School Diploma and 3 or more years work related experience required, Bachelor's Degree highly preferred
  • Experience working in a Telesales environment during the CMS Annual Enrollment Period
  • Knowledge of CMS compliance policies and procedures preferred
  • High attention to detail, quality and accuracy required
  • Strong coordination and organizational skills and ability to communicate effectively and follow-up where needed
  • Fast-learner and multi-tasking skills
  • Ability to work independently and within a team environment in a matrixed environment required
  • Strong interpersonal and prioritization skills preferred
  • Sales and/or training experience recommended
  • Excellent listening, written and verbal communication skills required
  • Adaptability, flexibility, and ability to manage through change in a fast-paced environment required

REQUIREMENTS
  • Health and Accident Insurance License
  • Must be available to work a flexible schedule that may include weekends and the day after Thanksgiving.
  • AHIP/Medicare Certification
  • Internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload

#TMHC

About the Company

T

Tailored Management

CONNECTING TOP TALENT WITH TOP-TIER OPPORTUNITIES

Tailored Management is a global staffing firm that specializes in partnering with large organizations that run their contingent labor program in a VMS/MSP environment. We have the unique capacity to support programs across all scopes and geographic locations from a single headquarters, successfully elevating program performance across the board and minimizing costs, miscommunication and delivery times. But what do we really do? We bring together the best talent with the greatest opportunities.

COMPANY SIZE
1,000 to 1,499 employees
INDUSTRY
Staffing/Employment Agencies
FOUNDED
1968
WEBSITE
https://www.tailoredmanagement.com/

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