Audit and Compliance Specialist
4 days ago
Job Summary:
We are seeking a highly skilled Quality Assurance Coordinator to join our team at BlueCross BlueShield of South Carolina. As a key member of our quality management team, you will be responsible for ensuring the highest level of quality in our operations.
Key Responsibilities:
- Assign, monitor, and audit the work of quality audit staff to ensure compliance with company policies and procedures.
- Monitor workloads, generate work samples, analyze outputs for timeliness and quality, and ensure deadlines are met.
- Serve as a subject matter expert and primary point of contact for coordination of quality assurance activities.
- Represent quality assurance on workgroups and in meetings.
- Assume managerial tasks as needed and act in a backup capacity.
- Develop work plans, objectives, priorities, methods, and procedures to improve quality performance.
- Write, update, and maintain all work instructions.
- Create reporting methodologies to analyze and measure effectiveness of implemented improvements.
- Use data to identify and implement qualitative and quantitative improvements focusing on prevention, planning, and quality control.
- Provide training for quality audit staff.
- Conduct quality targeted audits for all designated areas of responsibility as needed.
- Enter quality results and data into various databases and present audit findings to customers.
- Complete monthly quality reporting for customers, trend analysis, etc.
- Maintain effective ongoing communication with all departments and their management.
- Actively participate in calibration sessions, meetings, conference calls, and training.
- Provide leadership and support for the quality management system by gathering, synthesizing, and presenting information to all levels of division management.
Requirements:
- Bachelor's degree or equivalent work experience.
- 1 year of quality assurance experience.
- Microsoft Office proficiency.
- Demonstrated leadership skills.
- Strong analytical, presentation, customer service, persuasion, and organization skills.
- Advanced business math proficiency.
- Able to document problems and assist in their resolution.
- Able to document processes and identify areas for improvement.
- Excellent written and verbal communication skills.
Preferred Qualifications:
- ACA experience.
- Medicare advantage experience.
- Insurance sales experience.
Our Benefits:
- 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.
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