BlueCross BlueShield of South Carolina · 12 hours ago
Quality Assurance Analyst
BlueCross BlueShield of South Carolina is seeking a Quality Assurance Analyst to perform quality control audits and monitoring of departmental operations. The role involves identifying problems, analyzing causes, and making recommendations for improvements while ensuring quality standards are upheld across various functions.
Financial ServicesHealth CareHealth InsuranceInsuranceMedical
Responsibilities
Performs routine quality audits, reviews, or monitoring across various operations functions to ensure quality standards, procedures, and methodologies are being followed
Recognizes and documents any potential fraud and abuse situations
May provide one-on-one guidance to new hires upon completion of initial training
Provides necessary feedback or coaching to operations and training areas on errors assessed so that additional training can be initiated as needed
Compiles data and generates reports for operations areas on quality performance
Identifies areas of weakness and communicates recommendations on changes and improvements to training materials
Documents findings of analysis and prepares recommendations for implementation of new systems, procedures or organizational changes
Assists with training documentation and development of new processes and procedures
Remains current with all guidelines, work instructions, etc
Qualification
Required
High School Diploma or equivalent
1-year of related claims processing, customer service, auditing, training, analysis, or operations experience
Knowledge of Microsoft Office
Good analytical, customer service, and organization skills
Basic business math proficiency
Able to document problems and assist in their resolution
Able to document processes and identify areas for improvement
Effective written and verbal communication skills
Preferred
1-year of experience in the healthcare or insurance industry
Benefits
Subsidized health plans, dental and vision coverage
401k retirement savings plan with company match
Life Insurance
Paid Time Off (PTO)
On-site cafeterias and fitness centers in major locations
Education Assistance
Service Recognition
National discounts to movies, theaters, zoos, theme parks and more
Company
BlueCross BlueShield of South Carolina
For more than six decades, BlueCross BlueShield of South Carolina has been part of the national landscape. Our roots are firmly embedded in the state.
Funding
Current Stage
Late StageLeadership Team
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