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Quality Assurance Specialist

2 months ago

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

As a Quality Assurance Analyst with BlueCross BlueShield of South Carolina, you will play a vital role in ensuring the highest standards of quality in our operations. This position involves performing quality control audits, reviews, and monitoring across various functions to guarantee that our procedures and methodologies are being followed. Your attention to detail and analytical skills will be essential in identifying areas for improvement and making recommendations for change.

Key Responsibilities:
  • Conduct routine quality audits and reviews to ensure compliance with quality standards and procedures.
  • Recognize and document potential fraud and abuse situations.
  • Provide guidance and feedback to operations and training areas to improve quality performance.
  • Compile data and generate reports on quality performance.
  • Identify areas for improvement and communicate recommendations to management.

Requirements:
  • High School Diploma or equivalent.
  • One year of related experience in claims processing, customer service, auditing, training, analysis, or operations.
  • Good 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:

BlueCross BlueShield of South Carolina offers a comprehensive benefits package, including 401(k) retirement savings plan, subsidized health plans, life insurance, paid annual leave, and more. We are an equal opportunity employer and participate in E-Verify.