Remote Quality Assurance Specialist II

Premera Blue Cross; Charlotte (NC); Remote; USD 52,000 - 76,000; Full time

Job summary

Premera Blue Cross is hiring a Telecommuter Quality Auditor to assess claims, enrollment and customer service processes against applicable standards. You will plan audits, interpret requirements, and communicate results within defined scopes while coordinating with stakeholders.

The role emphasizes data analysis, root‑cause problem solving, and collaboration to strengthen quality assurance across the organization.

Qualifications

• High school diploma or GED is required.
• Three years in claims, customer service, or enrollment, including at least one year in quality audit.
• Bilingual proficiency in English/Spanish preferred.
• Quality 101 certification preferred.

Responsibilities

• Conduct audits in a professional, ethical and objective manner using applicable standards.
• Plan, develop and communicate audits within defined scope and schedule; conduct meetings as part of the audit.
• Maintain knowledge of procedural changes, audit techniques, and reference materials for assigned audit functions.
• Verify, document and communicate audit results, develop an audit report, and evaluate corrective actions.
• Resolve conflicts and discuss audit findings constructively to drive improvements.
• Identify trends and root causes of errors and recommend procedural improvements.
• Assist in consulting with external departments to resolve high-impact quality issues.
• Lead and participate in team meetings and Quality Review & Reporting initiatives.
• Explain quality principles and align the audit function with organizational goals.
• Other duties as assigned.

Skills

Quality auditing

Data analysis

Root-cause analysis

Education

High school diploma or GED

Quality 101 certification

Job description

Premera Blue Cross is hiring a Telecommuter Quality Auditor to assess claims, enrollment and customer service processes against applicable standards. You will plan audits, interpret requirements, and communicate results within defined scopes while coordinating with stakeholders.

The role emphasizes data analysis, root‑cause problem solving, and collaboration to strengthen quality assurance across the organization.