Audit and Compliance Specialist

4 days ago


Columbia, South Carolina, United States BlueCross BlueShield of South Carolina Full time

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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