Quality Assurance Specialist

4 days ago


Florence, 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 quality of our operations functions, including claims processing, customer service, and workflow management.

Key Responsibilities
  • Perform routine quality audits and reviews to ensure compliance with quality standards and procedures.
  • Identify and document potential fraud and abuse situations.
  • Provide guidance and coaching to new hires and operations teams on quality performance and improvement.
  • Compile data and generate reports on quality performance.
  • Develop and implement recommendations for process improvements.
Requirements
  • High school diploma or equivalent.
  • One year of related experience in claims processing, customer service, auditing, or operations.
  • Strong analytical, customer service, and organizational skills.
  • Basic business math proficiency.
  • Effective written and verbal communication skills.
  • Experience with Microsoft Office.
Preferred Qualifications
  • One year of experience in a healthcare or insurance industry.
What We Offer
  • Comprehensive benefits package, including 401(k) retirement savings plan, health plans, life insurance, and paid annual leave.
  • Opportunities for professional growth and development.
  • A dynamic and supportive work environment.


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