Remote Quality Auditor II — Process Improvement & Compliance

Premera Blue Cross; Yuma (AZ); Remoto; USD 65.000 - 90.000; Tempo pieno

Descrizione del lavoro

Premera Blue Cross is seeking a Telecommuter Quality Auditor to conduct audits, develop audit reports, and drive continuous improvement in quality assurance across business processes. The role emphasizes professional ethics, data interpretation, and cross‑functional collaboration.

The ideal candidate has a high school diploma, 3 years in claims/customer service/enrollment with at least 1 year in quality auditing, and optional bilingual English/Spanish. Quality 101 certification is preferred.

Competenze

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

Mansioni

• Conduct audits in a professional, ethical and objective manner using and interpreting applicable standards/requirements.
• Plan, develop, and communicate an audit within a defined scope, including resource scheduling; conduct necessary meetings.
• Maintain in-depth working knowledge of procedural changes, audit techniques, and plan automated systems, subsystems, and reference materials for assigned audit functions.
• Responsible for a wide variety of quality auditing tools and techniques. Verify, document and communicate audit results, develop an audit report, and evaluate the effectiveness of corrective action/follow-up.
• Resolve conflict directly and respectfully, engaging in challenging and important conversations to resolve audit findings.
• Identify trends and the root cause of errors and recommend improved procedures/guidelines to Operations proactively.
• Assist in consulting with external departments to help resolve high impact key business issues surrounding quality assurance.
• Help individuals and the team become stronger by actively participating, leading and facilitating team meetings and work groups regarding Quality Review & Reporting initiatives and incentives.
• Understand quality principles as they relate to business processes and explain the importance of aligning the audit function to the organization.
• Other duties as assigned.

Conoscenze

Quality auditing

Claims experience

Bilingual EN/ES

Formazione

High school diploma or GED

Quality 101 certification

Descrizione del lavoro

Premera Blue Cross is seeking a Telecommuter Quality Auditor to conduct audits, develop audit reports, and drive continuous improvement in quality assurance across business processes. The role emphasizes professional ethics, data interpretation, and cross‑functional collaboration.

The ideal candidate has a high school diploma, 3 years in claims/customer service/enrollment with at least 1 year in quality auditing, and optional bilingual English/Spanish. Quality 101 certification is preferred.