Remote Quality Assurance Auditor II

Premera Blue Cross; Little Rock (AR); Remoto; USD 48.000 - 72.000; Tempo pieno

Descrizione del lavoro

Premera Blue Cross is seeking a Quality Auditor to conduct audits in healthcare operations, ensuring compliance with standards and improving processes. The role is remote/telecommuter, with emphasis on data analysis and root-cause problem solving to drive operational excellence.

Ideal candidates will have at least 3 years in claims or enrollment work with a quality assurance background; multilingual ability (English/Spanish) is a plus, and Quality 101 certification is preferred.

Competenze

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

Mansioni

• Conduct audits professionally, ethically, and objectively using applicable standards.
• Plan, develop, and communicate audits within defined scope and schedule.
• Maintain knowledge of changes in procedures and audit techniques and plan systems accordingly.
• Verify, document, and communicate audit results; develop reports and evaluate corrective actions.
• Identify trends, root causes of errors, and propose improved procedures.
• Consult with external departments to resolve high-impact quality issues.
• Lead and participate in team meetings on Quality Review & Reporting initiatives.
• Explain quality principles and align auditing with organizational goals.

Conoscenze

Quality auditing

Data analysis

Root-cause analysis

Communication

Bilingual

Formazione

High school diploma or GED

Descrizione del lavoro

Premera Blue Cross is seeking a Quality Auditor to conduct audits in healthcare operations, ensuring compliance with standards and improving processes. The role is remote/telecommuter, with emphasis on data analysis and root-cause problem solving to drive operational excellence.

Ideal candidates will have at least 3 years in claims or enrollment work with a quality assurance background; multilingual ability (English/Spanish) is a plus, and Quality 101 certification is preferred.