Quality Assurance Analyst
Quality Assurance Analyst
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Salary Not Disclosed
1 Vacancy
Job Description
Summary
Under direct supervision performs quality control audits reviews or monitoring of departmental operations functions including but not limited to claims membership customer service/call center workflow processing support systems procedures documentation etc. Identifies problems analyzes cause and effect and makes recommendations for improvements.
Description
Location
This role is full time MF 8am5pm onsite at our Columbia SC location. Hybrid ability can be discussed post training with metrics met.
Government Clearance: This position requires the ability to obtain a security clearance which requires applicants to be a U.S. Citizen.
SCA Benefit Requirements: BlueCross BlueShield of South Carolina and its subsidiary companies have contracts with the federal government subject to the Service Contract Act (SCA). Under the McNamaraOHara Service Contract Act (SCA) employees cannot opt out of health benefits. Employees will receive supplemental pay until they are enrolled in health benefits 28 days after the hire date.
What You Will Do:
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
To Qualify for This Position You Will Need:
Required Education: High School Diploma OR equivalent
Required Work Experience: One 1 year of related claims processing customer service auditing training analysis or operations experience
Required Software and tools: Microsoft Office
Required Skills and Abilities: 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. Strong business math proficiency. Able to document problems and assist in their resolution. Able to document processes and identify areas for improvement. Strong written and verbal communication skills
What We Prefer:
TPL Medicaid/Medicare experience.
What We Can Do for You:
401(k) retirement savings plan with company match
Subsidized health plans and free vision coverage
Life insurance
Paid annual leave the longer you work here the more you earn
Nine paid holidays
Onsite cafeterias and fitness centers in major locations
Wellness programs and healthy lifestyle premium discount
Tuition assistance
Service recognition
Incentive Plan
Merit Plan
Continuing education funds for additional certifications and certification renewal
What to Expect Next:
After submitting your application our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with a recruiter to verify resume specifics and salary requirements.
Management will be conducting interviews with those candidates who qualify with prioritization given to those candidates who demonstrate the preferred qualifications.
Equal Employment Opportunity Statement
BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age race color national origin sex religion veteran status disability weight sexual orientation gender identity genetic information or any other legally protected status. Additionally as a federal contractor the company maintains affirmative action programs to promote employment opportunities for individuals with disabilitiesand protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal state and local laws and regulations.
We are committed to working with and providing reasonable accommodations to individuals with disabilities pregnant individuals individuals with pregnancyrelated conditions and individuals needing accommodations for sincerely held religious beliefs provided that those accommodations do not impose an undue hardship on the Company.
If you need special assistance or an accommodation while seeking employment please email or callext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a casebycase basis.
We participate in EVerify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Heres moreinformation.
Some states have required notifications. Heres more information.
Required Experience:
IC
Employment Type
Full-Time
