Remote Quality Assurance Auditor II

Premera Blue Cross; United States; Remote; USD 48,000 - 83,000; Full time

Benefits offered by this job

Medical coverage

401K employer match

Tuition assistance

On-site parking

Job summary

Premera Blue Cross is seeking a Quality Specialist II to oversee audits across our provider contact centers. This remote, nationwide role focuses on ensuring compliance with BCBS programs, FEP, LDLA, and corporate policies while examining claims, enrollment, and customer interactions.

You will plan audits, document results, identify root causes, and partner with teams to drive improvements. A high school diploma and 3 years of claims or enrollment experience (including quality audit) are

Qualifications

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

Responsibilities

• Audit processes professionally and objectively.
• Plan, conduct audits within defined scope and schedule resources.
• Maintain knowledge of procedural changes and audit techniques.
• Verify and report audit results; develop corrective actions.
• Identify root causes and propose improvements.
• Collaborate with departments to resolve issues and drive quality enhancements.
• Lead quality review and reporting initiatives.
• Explain audit importance to align with organizational goals.

Skills

Quality auditing

Auditing standards

Data analysis

Communication

Education

High school diploma or GED

Quality 101 certification

Job description

Premera Blue Cross is seeking a Quality Specialist II to oversee audits across our provider contact centers. This remote, nationwide role focuses on ensuring compliance with BCBS programs, FEP, LDLA, and corporate policies while examining claims, enrollment, and customer interactions.

You will plan audits, document results, identify root causes, and partner with teams to drive improvements. A high school diploma and 3 years of claims or enrollment experience (including quality audit) are