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CareFirst BlueCross BlueShield · 3 days ago

Quality Assurance Specialist II (Remote)

United States

Full-time

Remote

Mid, Senior Level

$48K/yr - $87K/yr

5+ years exp

CareFirst BlueCross BlueShield is a healthcare company focused on providing quality services. The Quality Assurance Specialist II is responsible for evaluating the accuracy of transactions and ensuring compliance with regulations while providing coaching and feedback to improve service quality.

Health CareNon ProfitService Industry

No H1B

Responsibilities

Audits assigned function (service, claims, enrollment) for accuracy, benefit payment, contract interpretation, and compliance with policies and procedures. Identifies, documents and reports transaction errors utilizing departmental quality monitoring templates in a timely manner to ensure prompt resolution

Conducts structured coaching and feedback sessions. Provides feedback and recommends improvement action plans for areas of deficiency within the group or for an individual

Participates in the creation and implementation of new methods, processes and/or products

Prepares reports and submits them to manager. Assists in development of special department projects and participates in divisional projects

Qualification

Quality AssuranceAuditingMicrosoft OfficeAnalytical skillsCommunication skillsOrganizational skillsInterpersonal skillsProblem-solving skills

Required

High School Diploma or GED

5 years Auditing, Quality Assurance, Operations, Training, Project Management or comparable work experience

Knowledge of quality assurance and production technologies

Proficient in Microsoft Office programs

Knowledge of industry standards, quality control techniques and procedures

Excellent communication skills both written and verbal

Excellent research and organizational skills

Strong Interpersonal skills

Extensive analytical and problem-solving skills

Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence

Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging