Patient Advocate QA Specialist (SDQ)

Position Summary:

We are looking for a highly detail-oriented Quality Assurance Specialist to join our team. In this role, you will evaluate and elevate the performance of Patient Advocates working within a complex medical record workflow environment. Success in this role requires a deep understanding of healthcare workflows, familiarity with insurance and pharmacy coordination, exceptional written communication skills, and the ability to independently audit and ensure compliance in a highly dynamic environment. 

Responsibilities:

• Communication & Empathy Auditing: Review asynchronous patient communications across messaging platforms to ensure interactions meet high-quality standards, utilizing exceptional written English, proper de-escalation techniques, and a professional, empathetic tone. 
• Insurance & Treatment Workflow QA: Audit comprehensive insurance administration tasks—including eligibility verification, benefits investigation, and prior authorizations—to ensure accuracy and timely patient access to care. 
• Care Coordination & EHR Monitoring: Evaluate how agents manage complex Electronic Health Records (EHR) and multi-system workflows. Ensure messages are triaged and routed correctly, and that administrative support provided to clinicians is error-free. 
• Pharmacy Operations Review: Monitor and assess pharmacy coordination efforts, verifying that prescription fulfillment issues and non-clinical medication processes are resolved accurately. 
• SOP Adherence & Operational Efficiency: Verify that agents are efficiently managing multiple applications simultaneously and consistently adhering to established standard operating procedures (SOPs). 
• Feedback & Continuous Improvement: Document audit findings meticulously and provide actionable feedback to guide agents through complex treatment workflows and improve overall patient resolution paths. 

Required Skills/Abilities:

• Advanced English proficiency

• Meticulous attention to detail, strong organizational skills, and effective time/queue management to meet auditing targets. 
• Analytical ability to identify trends in novel patient situations, assess how workflows are evolving, and escalate operational gaps appropriately. 
• Exceptional written communication skills to deliver clear, constructive, and empathetic feedback to team members. 
• Demonstrated ability to collaborate effectively with cross-functional teams, including Operations Managers, Physicians, Nurse Practitioners, pharmacy partners, and insurance stakeholders. 

Education and Experience:

• 2+ years of BPO experience, preferably in a QA, subject matter expert (SME), or senior support role within patient or medical operations. 
• 1+ year(s) of professional healthcare background (e.g., Medical Assistant, CNA, Healthcare Coordinator, Prior Authorization Specialist, or Virtual Medical Assistant). 
• Technical Skills: Hands-on experience navigating Electronic Health Records (EHR), multi-system medical workflows, prior authorizations, and remote healthcare support environments 

Benefits: 

• Insurance under ARS Humano Royal Plan (Option to upgrade to Max Royal Plan)
• Free snacks every day
• Free catered lunch every day
• Free catered dinner (for those on night shifts)
• Door-to-door transportation after 9:00 PM
• Happy hour on Fridays
• Holiday parties!
• An amazing, unique office environment (no cubes, no assigned workstations!)
• Growth and development opportunities (the most in the industry!)
• Professional development courses by leading business schools like BARNA
• Yoga and workout classes (coming soon!)
• Community service opportunities (#HoratioCares)
• Discounts at local restaurants and stores

Life At Horatio: 

Horatio is changing the way people experience life at work. Yes, that’s right - working at Horatio is much different than anywhere you’ve ever worked. Here’s what makes our vibe different:

• Employee First (but actually...): At Horatio, we are a family and that plays into everything we do. We know that our employees are the most important part of the team and we treat them as such! Just ask any member of our team about how different Horatio has been for them and why they love it so much! Or, feel free to check out our Instagram page hirehoratiord to see it for yourself. Whether it’s the free meals, concerts, clubs, yoga classes, or awesome office vibe, there’s something for everyone at Horatio!
• Cool Clients: We work with some of the fastest-growing and innovative companies in the world — and a lot of them are startups. That means no boring scripts and repetition. Instead, you will be challenged to provide clients with ideas, feedback, and new strategies based on what you are seeing each day. You’ll get to interact with clients directly too — it could be the head of the customer experience or even the CEO!
• Growth Opportunities: We’re a fast-growing company and have a lot of opportunities for new employees to grow within. A large number of our senior managers started as associates, proved themselves, and were promoted over and over again. If you are smart, hungry, and driven, the sky is the limit at Horatio!
• Wellness Program: We are committed to spread mental health awareness and promote its importance. Horatio has in-house clinical psychologists to take care of its employees.