CareFirst BlueCross BlueShield · 11 hours ago
Quality Assurance Specialist I (Remote)
United States
Full-time
Remote
Entry Level
$44K/yr - $81K/yr
2+ years expCareFirst BlueCross BlueShield is seeking a Quality Assurance Specialist I responsible for examining and evaluating the accuracy of transactions in accordance with regulations and company guidelines. The role involves auditing assigned functions for accuracy and compliance, mentoring less experienced staff, and identifying trends and training opportunities based on quality evaluations.
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
Performs in the role of coach and mentor to less tenured associates and acts as a subject matter expert on the operations. Assist with cross-training and skill development activities with less experienced staff in conjunction with management team
Proactively identifies trends and training opportunities based on quality evaluations
Qualification
Required
High School Diploma or GED
2 years progressive claims/customer service/enrollment &/or billing auditing experience, preferably in healthcare or insurance sector
Basic knowledge of quality assurance and production technologies
Proficient in Microsoft Office programs
Basic knowledge of industry standards, quality control techniques and procedures
Excellent communication skills both written and verbal
Excellent Research and organizational skills
Excellent decision making and interpersonal 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
Preferred
FACETS Experience
Benefits
Comprehensive benefits package
Various incentive programs/plans
401k contribution programs/plans
Company
CareFirst BlueCross BlueShield
CareFirst. It’s not just our name. It’s our promise.
5001-10000 employees
Funding
Current Stage
Late StageLeadership Team
Ja'Ron Bridges
Interim President and Chief Executive Officer
Doba Parushev
Vice President, Healthworx Ventures
Recent News
2025-10-02
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2025-08-07
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