Senior Quality Assurance Analyst

Summary
 Performs quality control audits to evaluate accuracy and effectiveness of departmental operations functions including, but not limited to, claims, membership, customer service/call center, workflow, processing support systems, procedures, documentation, etc. Identifies problems, analyzes cause and effect, and makes recommendations for improvements.
Description
 

Position Purpose

We are currently hiring for a Sr Quality Assurance Analyst, to join BlueCross BlueShield of South Carolina. In this role as a Sr Quality Assurance Analyst, you will perform quality control audits to evaluate the accuracy and effectiveness of departmental operations functions, including claims, membership, customer service/call center, workflow, processing support systems, procedures, documentation, etc. Identify problems, analyze cause and effect, and make recommendations for improvements.
Here is your opportunity to join a dynamic team at a diverse company with secure, community roots and an innovative future.

Logistics

Location: This role is remote, full time M-F 8am-5pm.

What You Will Do:

• Conduct focused quality audits across various operations functions to ensure quality standards, procedures, and methodologies are followed

• Document analysis findings and prepare recommendations for implementing new systems, procedures, or organizational changes to reduce errors

• Identify weaknesses and communicate recommendations on changes and improvements to training materials

• Provide feedback to management on errors detected, ensure errors are resolved, and provide long-range solutions to causes

• Develop and implement a quality control and improvement program based on targets identified through the quality reviews

• Monitor and evaluate the implementation of corrective action plans

• Compile data, provide feedback, and generate reports on quality performance for operations and/or training areas

• Train new employees and remain current with all guideline changes, work instructions, etc. Writes or assists in writing desk procedures and training materials for departments

• Assist with special projects such as testing for new business implementation or system changes, reviewing change requests, interpreting department workload, and statistical reports, assisting co-workers, etc

To Qualify for This Position, You Will Need:

• Required Education: High School Diploma OR equivalent

• One (1) year of related claims processing, customer service, auditing, training, analysis, or operations experience

• Two (2) years of experience performing quality audits.

• Required Software and tools: Microsoft Office

• Required Skills and Abilities: Strong analytical, presentation, customer service, persuasion, and organization skills

• Strong business math proficiency

• Able to document problems and assist in their resolution

• Able to document processes and identify areas for improvement

• Strong written and verbal communication skills

What We Prefer:

• 1-2 years auditing, claims processing, or customer service experience

What We Can Do for You:

• 401(k) retirement savings plan with company match

• Subsidized health plans and free vision coverage

• Life insurance

• Paid annual leave – the longer you work here, the more you earn

• Nine paid holidays

• On-site cafeterias and fitness centers in major locations

• Wellness programs and healthy lifestyle premium discount

• Tuition assistance

• Service recognition

• Incentive Plan

• Merit Plan

• Continuing education funds for additional certifications and certification renewal

What to Expect Next:

After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with a recruiter to verify resume specifics and salary requirements.

Management will be conducting interviews with those candidates who qualify, with prioritization given to those candidates who demonstrate the preferred qualifications.

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.

Some states have required notifications. Here's more information. 

Equal Employment Opportunity Statement

BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains Affirmative Action programs to promote employment opportunities for minorities, females, disabled individuals and veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.

We are committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities.

If you need special assistance or an accommodation while seeking employment, please e-mail [email protected] or call 1-800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.