Remote Quality Assurance & Audit Specialist II

Premera Blue Cross; Kansas City (MO); Remote; USD 55,000 - 75,000; Full time

Job summary

Premera Blue Cross is seeking a Quality Auditor to conduct audits professionally, ethically, and objectively, applying applicable standards. You will plan, develop, and communicate audits within defined scopes and schedules, maintaining up-to-date knowledge of procedures and audit techniques.

The role involves using various auditing tools to verify results and drive corrective actions. The ideal candidate has a high school diploma or GED, 3 years in claims/customer enrollment with QA experience,

Qualifications

• High school diploma or GED (Required).
• Three (3) years of claims, customer service or enrollment work experience, including one (1) year of quality audit/quality assurance (Required).
• Bilingual proficiency in English/Spanish may be preferred with clear articulation (Preferred).
• Quality 101 certification (Preferred).

Responsibilities

• Conduct audits in a professional, ethical and objective manner using and interpreting applicable standards/requirements.
• Plan, develop, and communicate an audit within a defined scope, including resource scheduling. Conduct necessary meetings in performance of the audit.
• Maintain in-depth working knowledge of procedural changes, audit techniques, and plan automated systems, subsystems, and reference materials for assigned audit functions.
• Responsible for a wide variety of quality auditing tools and techniques. Verify, document and communicate audit results, develop an audit report, and evaluate the effectiveness of corrective action/follow-up.
• Resolve conflict directly and respectfully, engaging in challenging and important conversations to resolve audit findings.
• Identify trends and the root cause of errors and recommend improved procedures/guidelines to Operations proactively.
• Assist in consulting with external departments to help resolve high impact key business issues surrounding quality assurance.
• Help individuals and the team become stronger by actively participating, leading and facilitating team meetings and work groups regarding Quality Review & Reporting initiatives and incentives.
• Understand quality principles as they relate to business processes and explain the importance of aligning the audit function to the organization.

Skills

Quality auditing

Data analysis

Root cause analysis

Quality standards

Education

High school diploma or GED

Job description

Premera Blue Cross is seeking a Quality Auditor to conduct audits professionally, ethically, and objectively, applying applicable standards. You will plan, develop, and communicate audits within defined scopes and schedules, maintaining up-to-date knowledge of procedures and audit techniques.

The role involves using various auditing tools to verify results and drive corrective actions. The ideal candidate has a high school diploma or GED, 3 years in claims/customer enrollment with QA experience,