Remote Quality Specialist II – Audits & Compliance

Premera Blue Cross; Juneau (AK); Remoto; USD 60.000 - 85.000; Tempo integral

Resumo da vaga

Premera Blue Cross in the United States is seeking a Quality Auditor to conduct audits professionally, ethically, and objectively, applying standards and requirements to gain accurate findings across claims, enrollment, and customer service operations. This role is telecommuter-friendly and focuses on improving quality and compliance.

You will develop audit plans, communicate findings, advise on corrective actions, and help resolve high-impact issues with cross-functional teams while promoting

Qualificações

• High school diploma or GED required.
• Three (3) years of claims, customer service or enrollment work experience, including one (1) year of quality audit, quality control, or quality assurance experience.
• Bilingual proficiency in English/Spanish preferred.

Responsabilidades

• Conduct audits in a professional, ethical and objective manner using applicable standards/requirements.
• Plan, develop, and communicate an audit within a defined scope, including resource scheduling.
• Maintain knowledge of procedural changes, audit techniques, and reference materials for assigned audits.
• Verify, document and communicate audit results, develop an audit report, and evaluate corrective actions.
• Resolve conflicts directly and respectfully while addressing audit findings.
• Identify trends and root causes of errors to recommend improved procedures and guidelines.
• Assist in consulting with external departments to resolve high-impact business issues related to quality assurance.
• Lead and facilitate team meetings and workgroups on Quality Review & Reporting initiatives.
• Explain the importance of aligning the audit function to the organization.

Conhecimentos

Quality auditing

Root-cause analysis

Communication

Formação

High School Diploma or GED

Descrição da vaga

Premera Blue Cross in the United States is seeking a Quality Auditor to conduct audits professionally, ethically, and objectively, applying standards and requirements to gain accurate findings across claims, enrollment, and customer service operations. This role is telecommuter-friendly and focuses on improving quality and compliance.

You will develop audit plans, communicate findings, advise on corrective actions, and help resolve high-impact issues with cross-functional teams while promoting