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Senior Quality Assurance Analyst
2 months ago
We are seeking a highly skilled Senior Quality Assurance Analyst to join our team at BlueCross BlueShield of South Carolina. As a key member of our operations team, you will be responsible for ensuring the quality and accuracy of our departmental operations functions.
Key Responsibilities- Conduct quality control audits to evaluate the accuracy and effectiveness of our 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.
- 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 proficiency, including Excel.
- One year of experience in a healthcare or insurance industry.
- Experience with auditing calls and claims.
- 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.
