Quality Assurance Analyst

Job Description

Minimally qualified candidates will have experience or skills in the following areas:

• Attention to detail
• Ability to research, interpret, and apply relevant WI statutes, administrative code, policies and procedures
• Ability to analyze and compare large data sets and files to identify discrepancies, inconsistencies, and trends; investigate and determine root causes of data or file discrepancies in collaboration with technical staff, vendors, and business teams
• Working knowledge of data exchange processes, file layouts, and/or eligibility and enrollment data
• Experience troubleshooting data issues and documenting findings, resolutions, and procedures
• Intermediate proficiency in Microsoft Excel, including formulas, filtering, sorting, pivot tables, and lookup functions
• Ability to understand and communicate complex data and information to both technical and non-technical audiences
• Critical and analytical thinking for effective problem-solving
• Working collaboratively with different teams across an organization
• Capacity to learn new tools, systems, applications, and ability to document procedures to assist others in using them
• Sound time management and ability to manage multiple concurrent assignments
• Obtain relevant information without disclosing confidential information
• Ability to interact positively with a variety of persons at different levels
• Excellent written, oral, and interpersonal skills

• Support OSHP program managers and EIU case managers in addressing vendor queries related to historical member benefits enrollment and eligibility information
• Support OSHP life insurance program manager and Benefits Initiation Section 3 staff in administering life insurance enrollment and eligibility, handling escalated eligibility and enrollment questions resulting from discrepancies between My Insurance Benefits system, Securian Financial billing system, and employer records
• Support the Life Insurance Premium Waiver interim process
• Assist in the development and documentation of new ETF procedures related to eligibility and enrollment administration for the life insurance program
• Conduct the life insurance salary audit, verifying consistency between employer reported salary information and current on file information; work with EIU case managers to resolve errors
• Support the vendor file discrepancy process following MIBs implementation — reviewing error reports returned from Benefitfocus, determining updates needed in system, from employers, or by plans
• Conduct full-file comparisons and data reconciliation activities between vendor, employer, and ETF systems to identify discrepancies and ensure data integrity
• Research, analyze, and troubleshoot eligibility and enrollment discrepancies, coordinating with ETF technical staff, vendors, and business teams to identify root causes and implement corrective actions
• Assist with monitoring and resolving vendor file transmission issues, including 834 file processing and SFTP connectivity concerns
• Support testing and validation activities related to eligibility, enrollment, and

• Minimum of three years of professional experience in benefits administration, eligibility and enrollment operations, insurance operations, or a closely related field, including interpretation and application of statutes, administrative code, policies, procedures, and business rules
• Data analysis, reconciliation, and validation across files, reports, and systems to identify discrepancies, inconsistencies, and trends, including use of Microsoft Excel for comparison and analysis
• Research and resolution of eligibility, enrollment, billing, or vendor file discrepancies, including root cause identification, corrective action coordination, and documentation of findings and outcomes
• Serving as a liaison between internal staff, technical teams, vendors, and stakeholders to communicate issues, exchange information, and support resolution of complex eligibility and enrollment issues

• Advanced Microsoft Excel skills, including use of formulas, pivot tables, lookup functions, filtering, and sorting to analyze and compare large or complex data sets
• Experience performing data reconciliation and file comparison across multiple systems to identify discrepancies and support data integrity and issue resolution
• Knowledge of eligibility, enrollment, and benefits administration processes, including understanding of data exchange between employers, vendors, and internal systems
• Strong analytical and problem-solving skills, including ability to investigate data issues, identify root causes, and support resolution in collaboration with technical and business partners
• Strong communication, organization, and documentation skills, including ability to clearly convey complex information, manage multiple priorities, and document findings and resolutions