Senior Quality Assurance Analyst

Southcarolinablues; Florence (SC); Sur place; USD 42 000 - 65 000; Plein temps

Avantages offerts par ce poste

Subsidized health plans

401k retirement savings plan with公司

Life Insurance

Paid Time Off

On-site cafeterias and fitness centers

Education Assistance

Service Recognition

Discounts

Résumé du poste

BlueCross BlueShield of South Carolina in Florence, SC is seeking a Quality Control Auditor to evaluate the accuracy and effectiveness of departmental operations, including claims, member services, and call center workflows. This full-time, on-site role requires attention to detail and strong analytical skills.

You will perform audits, document findings, and recommend improvements to training and processes, helping implement corrective actions.

Qualifications

• High School Diploma or equivalent required.
• 1 year of related claims processing, customer service, auditing, training, analysis or operations experience.
• 2 years of experience performing quality audits.

Responsabilités

• Conducts focused quality audits across various operations functions to ensure quality standards, procedures, and methodologies are followed.
• Documents findings and prepares recommendations for implementation of new systems, procedures, or organizational changes to reduce errors.
• Identifies areas of weakness and communicates recommendations on changes and improvements to training materials.
• Provides feedback to management on errors detected and ensures errors are resolved.
• Develops and implements a quality control and improvement program based on targets identified through quality reviews.
• Monitors and evaluates the implementation of corrective action plans.
• Compiles data, provides feedback, and generates reports for operations/training areas on quality performance.
• Train new employees and stay current with guideline changes and work instructions.
• Writes or assists in writing desk procedures and training materials for departments.

Connaissances

Analytical skills

Presentation skills

Customer service

Organization

Business math

Written communication

Formation

High School Diploma or equivalent

Outils

Microsoft Office

Description du poste

### To learn more about our website privacy policy, click on this .# **Summary**Performs quality control audits to evaluate accuracy and effectiveness of departmental operations functions including, but not limited to, claims, membership, customer service/call center, workflow, processing support systems, procedures, documentation, etc. Identifies problems, analyzes cause and effect, and makes recommendations for improvements.# **Description****Location**This role is full time M-F 8am-5pm, onsite at our Florence, SC location.Government Clearance: This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen.SCA Benefit Requirements: BlueCross BlueShield of South Carolina and its subsidiary companies have contracts with the federal government subject to the Service Contract Act (SCA). Under the McNamara-O'Hara Service Contract Act (SCA), employees cannot opt out of health benefits. Employees will receive supplemental pay until they are enrolled in health benefits 28 days after the hire date.**What You Will Do:*** Conducts focused quality audits across various operations functions to ensure quality standards, procedures, and methodologies are being followed* Documents findings of analysis and prepares recommendations for implementation of new systems, procedures, or organizational changes to reduce errors* Identifies areas of weakness and communicates recommendations on changes and improvements to training materials* Provides feedback to management on errors detected, ensures errors are resolved, and provides long-range solutions to causes* Develops and implements a quality control and improvement program based on targets identified through the quality reviews* Monitors and evaluates the implementation of corrective action plans* Compiles data, provides feedback, and generates reports for operations and/or training areas on quality performance* Train new employees and remains current with all guideline changes, work instructions, etc* Writes or assists in writing desk procedures and training materials for departments.* Provides assistance with special projects such as testing for new business implementation or system changes, reviewing change requests, interpreting department workload, statistical reports, assisting co-workers, etc.**To Qualify for This Position, You Will Need:*** Required Education: High School Diploma OR equivalent* Required Work Experience: 1 year of related claims processing, customer service, auditing, training, analysis or operations experience. 2 years of experience performing quality audits* Required Software and tools: Microsoft Office* Required Skills and Abilities: Strong analytical, presentation, customer service, persuasion, and organization skills. Strong business math proficiency. Able to document problems and assist in their resolution. Able to document processes and identify areas for improvement. Strong written and verbal communication skills.**Our Comprehensive Benefits Package Includes The Following: We offer our employees great benefits and rewards. You will be eligible to participate in our benefits program the first of the month following 28 days of employment*** Subsidized health plans, dental and vision coverage* 401k retirement savings plan with company match* Life Insurance* Paid Time Off (PTO)* On-site cafeterias and fitness centers in major locations* Education Assistance* Service Recognition* National discounts to movies, theaters, zoos, theme parks and more**What We Can Do for You:** We strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.**What To Expect Next**: After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.**Equal Employment Opportunity Statement**BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.If you need special assistance or an accommodation while seeking employment, please email [e-mail] or call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here'sSome states have required notifications. Here's.