Quality Assurance Analyst - Healthcare Claims

Southcarolinablues; Florence (SC); On-site; USD 42,000 - 65,000; Full time

Benefits offered by this job

Health benefits

401(k) plan

Paid Time Off

On-site cafeterias and fitness centers

Education Assistance

Job summary

BlueCross BlueShield of South Carolina is seeking a Quality Assurance Analyst to perform routine audits across claims, membership, and call center operations at our Florence, SC site. The role requires US citizenship for security clearance and offers a comprehensive benefits package.

The analyst will monitor quality standards, document findings, and provide coaching to improve processes and training materials. On-site, full-time position with standard M-F hours.

Qualifications

• High School Diploma or equivalent required.
• 1 year of related claims processing, customer service, auditing, training, analysis, or operations experience preferred.
• Proficiency in Microsoft Office and basic analytical skills required.

Responsibilities

• Perform routine quality audits, reviews, or monitoring across operations to ensure quality standards.
• Identify potential fraud or abuse and document findings.
• Provide coaching to training areas on errors to initiate additional training.
• Compile data and generate reports on quality performance for operations.
• Suggest improvements to training materials and processes.

Skills

Quality audits

Data analysis

Microsoft Office

Customer service

Training

Education

High School Diploma or equivalent

Tools

Microsoft Office

Job description

BlueCross BlueShield of South Carolina is seeking a Quality Assurance Analyst to perform routine audits across claims, membership, and call center operations at our Florence, SC site. The role requires US citizenship for security clearance and offers a comprehensive benefits package.

The analyst will monitor quality standards, document findings, and provide coaching to improve processes and training materials. On-site, full-time position with standard M-F hours.