Senior Quality Assurance Auditor

4 days ago

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

BlueCross BlueShield of South Carolina is seeking a skilled Senior Quality Assurance Auditor to join our team. As a Senior Quality Assurance Auditor, you will be responsible for conducting quality control audits to evaluate the accuracy and effectiveness of departmental operations functions. This includes identifying problems, analyzing cause and effect, and making recommendations for improvements.

Key Responsibilities

Conduct focused quality audits across various operations functions to ensure quality standards, procedures, and methodologies are being followed.
Document findings of analysis and prepare recommendations for implementation of new systems, procedures, or organizational changes to reduce errors.
Identify areas of weakness and communicate recommendations on changes and improvements to training materials.
Provide feedback to management on errors detected, ensure errors are resolved, and provide long-range solutions to causes.
Develop and implement a quality control and improvement program based on targets identified through the quality reviews.
Monitor and evaluate the implementation of corrective action plans.
Compile data, provide feedback, and generate reports for operations and/or training areas on quality performance.
Train new employees and remain current with all guideline changes, work instructions, etc.
Write or assist in writing desk procedures and training materials for departments.
Provide 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.

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.
Strong analytical, presentation, customer service, persuasion, and organization skills
Strong business math proficiency
Able to document processes and identify areas for improvement
Effective written and verbal communication skills
Microsoft Office to include strong proficiency with Excel creating data tables and using formulas, etc.

Preferred Qualifications

One year of experience in a healthcare or insurance industry
Experience with auditing calls and claims

What We Offer

BlueCross BlueShield of South Carolina offers a comprehensive benefits package, including 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 in significant locations, wellness programs, and a healthy lifestyle premium discount, tuition assistance, and service recognition.

Equal Employment Opportunity

BlueCross BlueShield of South Carolina is an equal opportunity employer and welcomes applications from diverse candidates. We are committed to creating an 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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