Remote Quality Assurance Specialist II

Premera Blue Cross; Eagle (ID); Remoto; USD 48.000 - 83.000; Tempo pieno

Descrizione del lavoro

Premera Blue Cross is seeking a Quality Specialist II for the Provider Contact Center Quality Program. You will audit transactions such as claims, enrollment and customer inquiries to ensure accuracy, timeliness and adherence to BCBS standards and FEP/audit requirements.

The role supports offshore operations and collaborates with stakeholders to drive continuous improvement. The position requires strong quality assurance experience, attention to detail, and the ability to work in a fast-paced

Competenze

• Three years of claims, customer service, or enrollment experience, including one year in quality audit/quality assurance.
• Bilingual ability (English/Spanish) preferred.
• Quality 101 certification preferred.

Mansioni

• Conduct audits professionally, ethically and objectively.
• Plan, develop, and communicate audits within defined scope.
• Maintain knowledge of audit techniques and automated systems.
• Verify and report audit results; evaluate corrective actions.
• Identify trends and root causes; recommend improvements to operations.
• Consult with external departments to resolve quality issues.
• Lead team discussions on Quality Review & Reporting initiatives.
• Explain how audit function aligns with the organization.

Conoscenze

Quality auditing

Customer service

Claims processing

Enrollment work

Bilingual English/Spanish

Formazione

High school diploma or GED

Quality 101 certification

Descrizione del lavoro

Premera Blue Cross is seeking a Quality Specialist II for the Provider Contact Center Quality Program. You will audit transactions such as claims, enrollment and customer inquiries to ensure accuracy, timeliness and adherence to BCBS standards and FEP/audit requirements.

The role supports offshore operations and collaborates with stakeholders to drive continuous improvement. The position requires strong quality assurance experience, attention to detail, and the ability to work in a fast-paced