Job description
Summary
We are hiring a Quality Assurance Analyst! In this role under direct supervision, performs quality control audits, reviews, or monitoring 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.
The ideal candidate for this role will have excellent time management and organizational skills. In addition, they will pay strong attention to detail. If this sounds like you, we would love for you to join our team!
Description
Logistics:
This position is full time (40 hours/week) dayshift 8:00am-5:00 pm Monday-Friday. This role is onsite in Florence, SC.
What You’ll Do:
- Performs routine quality audits, reviews, or monitoring across various operations functions to ensure quality standards, procedures, and methodologies are being followed. Recognizes and documents any potential fraud and abuse situations. May provide one on one guidance to new hires upon completion of initial training.
- Provides necessary feedback or coaching to operations and training areas on errors assessed so that additional training can be initiated as needed. Compiles data and generates reports for operations areas on quality performance.
- Identifies areas of weakness and communicates recommendations on changes and improvements to training materials. Documents findings of analysis and prepares recommendations for implementation of new systems, procedures, or organizational changes.
- Assists with training documentation and development of new processes and procedures. Remains current with all guidelines, work instructions, etc.
To Qualify for this Position, You’ll Need:
- High School Diploma or equivalent
- One (1) year of related claims processing, customer service, auditing, training, analysis, or operations experience.
- Good analytical, customer service, and organization skills. Basic business math proficiency. Able to document problems and assist in their resolution. Able to document processes and identify areas for improvement. Effective written and verbal communication skills.
- Microsoft Office.
We Prefer That You Have:
- 1 year-of experience in a healthcare or insurance industry.
What We Can Do for You:
You are not alone. We are here to support you:
Our comprehensive benefits package includes:
- 401(k) retirement savings plan with company match
- Subsidized health plans and free vision coverage
- Life insurance
- Paid annual leave – the longer you work here, the more you earn
- Nine paid holidays
- On-site cafeterias and fitness centers in major locations
- Wellness programs and healthy lifestyle premium discount
- Tuition assistance
- Service recognition
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 a recruiter to verify resume specifics and salary requirements.
We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.
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 minorities, females, disabled individuals and 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 physical and mental disabilities.
If you need special assistance or an accommodation while seeking employment, please e-mail abilities@bcbssc.com or call 1-800-288-2227, ext. 43172 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.
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