Senior Quality Assurance Auditor – Claims & Ops

BlueCross and BlueShield of South Carolina; Florence (SC); On-site; USD 42,000 - 62,000; Full time

Benefits offered by this job

401k retirement savings plan with 회사 매

Life Insurance

Paid Time Off

On-site cafeterias

Education Assistance

Service Recognition

National discounts

Job summary

BlueCross BlueShield of South Carolina is seeking a Quality Control Auditor to assess accuracy and effectiveness of departmental operations, including claims, membership, and customer service functions at our Florence, SC site. The role requires sharp analytical skills and the ability to recommend improvements.

You will conduct focused audits, document findings, train staff, and help 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 quality audits experience.
• Microsoft Office proficiency required.
• Strong analytical, presentation, customer service, persuasion, and organization skills; strong business math proficiency.

Responsibilities

• Conducts focused quality audits across various operations to ensure adherence to quality standards and methodologies.
• Documents findings and prepares recommendations for new systems, procedures, or changes to reduce errors.
• Identifies weaknesses and communicates improvement recommendations for training materials.
• Provides management with feedback on errors and ensures resolution with long-range solutions.
• Develops and implements a quality control/improvement program based on identified targets.
• Monitors and evaluates corrective action plan implementations.
• Compiles data and generates reports on quality performance for operations/training areas.
• Trains new employees and stays current with guideline changes and instructions.
• Writes or assists in writing desk procedures and training materials for departments.
• Assists with special projects such as testing for new business or system changes.

Skills

Analytical

Presentation

Customer service

Persuasion

Organization

Business math

Education

High School Diploma or equivalent

Tools

Microsoft Office

Job description

BlueCross BlueShield of South Carolina is seeking a Quality Control Auditor to assess accuracy and effectiveness of departmental operations, including claims, membership, and customer service functions at our Florence, SC site. The role requires sharp analytical skills and the ability to recommend improvements.

You will conduct focused audits, document findings, train staff, and help implement corrective actions.