BlueCross BlueShield of South Carolina

Quality Assurance Analyst

BlueCross BlueShield of South Carolina

full-time

Posted on:

Location Type: Hybrid

Location: ColumbiaSouth CarolinaUnited States

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About the role

  • Performs routine quality audits, reviews, or monitoring across various operations functions to ensure quality standards, procedures, and methodologies are being followed.
  • Recognizes and documents any potential fraud and abuse situations.
  • May provide one on one guidance to new hires upon completion of initial training.
  • Provides necessary feedback or coaching to operations and training areas on errors assessed so that additional training can be initiated as needed.
  • Compiles data and generates reports for operations areas on quality performance.
  • Identifies areas of weakness and communicates recommendations on changes and improvements to training materials.
  • Documents findings of analysis and prepares recommendations for implementation of new systems, procedures or organizational changes.
  • Assists with training documentation and development of new processes and procedures.
  • Remains current with all guidelines, work instructions, etc.

Requirements

  • High School Diploma or equivalent
  • 1-year of related claims processing, customer service, auditing, training, analysis, or operations experience
  • Knowledge of Microsoft Office
  • Good analytical, customer service, and organization skills
  • Basic business math proficiency
  • Able to document problems and assist in their resolution
  • Able to document processes and identify areas for improvement
  • Effective written and verbal communication skills
Benefits
  • Subsidized health plans, dental and vision coverage
  • 401k retirement savings plan with company match
  • Life Insurance
  • Paid Time Off (PTO)
  • On-site cafeterias and fitness centers in major locations
  • Education Assistance
  • Service Recognition
  • National discounts to movies, theaters, zoos, theme parks and more
Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools
claims processingauditingdata analysisbusiness math
Soft Skills
analytical skillscustomer serviceorganizational skillsproblem documentationcommunication skills
Certifications
High School Diploma