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Quality Assurance Analyst

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BlueCross BlueShield of South Carolina

2mo ago

  • Job
    Full-time
    Junior Level
  • Columbia, +1
  • Quick Apply

AI generated summary

  • You need a high school diploma, 1 year of related experience, proficiency in Microsoft Office, strong analytical and communication skills, and ability to document and improve processes.
  • You will conduct quality audits, document findings, provide feedback and coaching, generate reports, identify weaknesses, assist in training, and ensure compliance with guidelines and procedures.

Requirements

  • Required Education: High School Diploma OR equivalent
  • Required Work Experience: One (1) year of related claims processing, customer service, auditing, training, analysis, or operations experience
  • Required Software and tools: Microsoft Office
  • Required Skills and Abilities: 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. 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

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

FAQs

Do we support remote work?

Yes, we do support remote work but in a hybrid format after training and meeting specific metrics.

Is a security clearance required for this position?

Yes, this position requires the ability to obtain a security clearance, which necessitates applicants to be U.S. Citizens.

What are the working hours for this position?

The working hours for this position are full-time, Monday through Friday, from 8 AM to 5 PM.

What qualifications are required for this role?

Candidates need a High School Diploma or equivalent and at least one year of related experience in claims processing, customer service, auditing, training, analysis, or operations.

Are there any preferred qualifications for this position?

Yes, experience with TPL (Third Party Liability), Medicaid, or Medicare is preferred.

What kind of skills are necessary for this position?

Required skills include good analytical, customer service, organization skills, basic business math proficiency, and effective written and verbal communication skills.

What benefits do employees receive?

Employees receive benefits such as a 401(k) retirement savings plan with company match, subsidized health plans, free vision coverage, life insurance, paid annual leave, paid holidays, wellness programs, tuition assistance, and more.

How will I be contacted after submitting my application?

After submitting your application, the recruiting team will review your resume and may conduct a brief telephone interview or email communication to verify the specifics of your resume and salary requirements.

What is the company's stance on equal employment opportunity?

BlueCross BlueShield of South Carolina is committed to nondiscrimination in employment and promotes opportunities regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information, or any other protected status.

How can I request an accommodation during the application process?

If you need special assistance or an accommodation while seeking employment, you can email mycareer.help@bcbssc.com or call 800-288-2227, ext. 47480, with the nature of your request.

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BlueCross BlueShield of South Carolina

South Carolina’s largest and oldest health insurance company

Finance
Industry
10,001+
Employees
1946
Founded Year

Mission & Purpose

BlueCross BlueShield of South Carolina, the state's largest insurance company, has been a part of the national landscape for over six decades. With an A+ Superior rating from A.M. Best, the company is a leading government contract administrator and operates one of the most advanced data processing centers in the Southeast. BlueCross offers employees robust benefits, including retirement plans, health coverage, and education assistance, while fostering a culture of community support, with employees actively contributing to numerous nonprofit organizations each year.