Quality Assurance Analyst - Insurance & Claims

001 BlueCross and BlueShield of South Carolina; Columbia (SC); On-site; USD 42,000 - 56,000; Full time

Benefits offered by this job

Health plans

Dental & Vision

401k with company match

Life Insurance

PTO

On-site facilities

Education assistance

Service recognition

National discounts

Job summary

BlueCross BlueShield of South Carolina is seeking a Quality Control Auditor to perform routine audits across claims processing, customer service, and related operations. You will identify fraud, coach new hires, and generate quality reports.

The role requires strong analytical and communication skills, with proficiency in Microsoft Office and formal documentation of findings. This full-time position is based in Columbia, SC, offering benefits and opportunities to improve processes and training

Qualifications

• High School Diploma or equivalent required.
• 1 year of related claims processing, customer service, auditing, training, analysis, or operations experience.
• Strong analytical skills and ability to communicate effectively in writing and speech.
• Proficiency with Microsoft Office and data documentation.

Responsibilities

• Performs routine quality audits across operations to ensure standards are followed.
• Recognizes and documents potential fraud and abuse situations.
• Provides coaching to new hires after initial training.
• Delivers feedback to improve training and materials.
• Compiles data and generates reports on quality performance.
• Identifies weaknesses and recommends training/material changes.
• Documents findings and proposes new systems or procedures.
• Assists with training documentation and development.
• Stays current with guidelines and work instructions.

Skills

Analytical

Customer service

Organization

Business math

Issue documentation

Process documentation

Written & verbal communication

Education

High School Diploma or equivalent

Tools

Microsoft Office

Job description

BlueCross BlueShield of South Carolina is seeking a Quality Control Auditor to perform routine audits across claims processing, customer service, and related operations. You will identify fraud, coach new hires, and generate quality reports.

The role requires strong analytical and communication skills, with proficiency in Microsoft Office and formal documentation of findings. This full-time position is based in Columbia, SC, offering benefits and opportunities to improve processes and training