Remote Quality Assurance Auditor II

Premera Blue Cross; Lansing (MI); Remote; USD 50,000 - 65,000; Full time

Job summary

Premera Blue Cross is seeking a quality auditor to work remotely, focusing on audits of claims, enrollment, and customer service processes. You will plan and conduct audits, document results, and help drive quality improvements across departments.

The role requires a high school diploma or GED and at least three years in claims, customer service, or enrollment, with one year in quality audit or assurance. Bilingual ability may be preferred.

Qualifications

• High school diploma or GED required.
• Three years of claims, customer service or enrollment work experience, including one year of quality audit/quality assurance.
• Bilingual English/Spanish ability may be preferred.

Responsibilities

• Conduct audits professionally, ethically, and objectively using applicable standards.
• Plan, develop, and communicate an audit within a defined scope and schedule meetings.
• Maintain knowledge of procedural changes, audit techniques, and reference materials.
• Use auditing tools to verify, document, communicate results, and evaluate corrective actions.
• Resolve conflicts respectfully and discuss audit findings with stakeholders.
• Identify trends and root causes; suggest improved procedures.
• Consult with external departments to resolve quality issues.
• Lead and participate in team meetings focused on Quality Review & Reporting.
• Explain quality principles and align audit function with the organization.
• Perform other duties as assigned.

Skills

Quality auditing

Claims/customer service experience

Quality assurance experience

Education

High school diploma or GED

Job description

Premera Blue Cross is seeking a quality auditor to work remotely, focusing on audits of claims, enrollment, and customer service processes. You will plan and conduct audits, document results, and help drive quality improvements across departments.

The role requires a high school diploma or GED and at least three years in claims, customer service, or enrollment, with one year in quality audit or assurance. Bilingual ability may be preferred.