Quality Assurance Analyst

3 days ago


Myrtle Beach, South Carolina, United States BlueCross BlueShield of South Carolina Full time
Job Summary

We are seeking a highly skilled Quality Assurance Analyst to join our team at BlueCross BlueShield of South Carolina. As a Quality Assurance Analyst, you will play a critical role in ensuring the accuracy and effectiveness of our departmental operations functions.

Key Responsibilities
  • Conduct quality control audits to evaluate the accuracy and effectiveness of various operations functions, including claims, membership, customer service, and workflow.
  • Identify problems, analyze causes, and make recommendations for improvements.
  • Develop and implement a quality control and improvement program based on targets identified through quality reviews.
  • Monitor and evaluate the implementation of corrective action plans.
  • Compile data, provide feedback, and generate reports on quality performance.
  • Train new employees and remain current with all guideline changes, work instructions, and procedures.
  • Assist with special projects, such as testing for new business implementation or system changes.
Requirements
  • High School Diploma or equivalent.
  • One year of related claims processing, customer service, auditing, training, analysis, or operations experience.
  • Two years of experience performing quality audits.
Preferred Qualifications
  • One year of experience in a healthcare or insurance industry.
  • Experience with auditing calls and claims.
What We Offer
  • 401(k) retirement savings plan with company match.
  • Fantastic health plans and free vision coverage.
  • Life insurance.
  • Paid annual leave.
  • Nine paid holidays.
  • On-site cafeterias and fitness centers.
  • Wellness programs and a healthy lifestyle premium discount.
  • Tuition assistance.
  • Service Recognition.
About Us

We are committed to creating a diverse and inclusive workplace where employees can develop their skills, advance their careers, and contribute their unique abilities to the growth of our company.



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