BlueCross BlueShield of South Carolina
Senior Quality Assurance Analyst
BlueCross BlueShield of South Carolina, Florence, South Carolina, United States, 29506
SummaryPerforms quality control audits to evaluate accuracy and effectiveness 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
Position
Purpose
We are currently hiring for a Senior Quality Assurance Analyst-PGBA to join BlueCross BlueShield of South Carolina. In this role as a Senior Quality Assurance Analyst-PGBA, you will be responsible for performing quality control audits to evaluate accuracy and effectiveness 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.
Here is your opportunity to join a dynamic team at a diverse company with secure, community roots and an innovative future.
Logistics :
This position is full-time (40 hours/week, 8 hours/day) Monday - Friday in a typical office environment. This role is located onsite in Florence, SC.
What You'll Do:Conduct focused quality audits across various operations functions to ensure quality standards, procedures, and methodologies are being followed
Document findings of analysis and prepare recommendations for implantation of new systems, procedures, or organizational changes to reduce errors
Identify areas of weakness and communicate recommendations on changes and improvements to training materials
Provide feedback to management on errors detected, ensure errors are resolved, and provide long-range solutions to causes
Develop and implement a quality control and improvement program based on targets identified through the quality reviews. Monitor and evaluate the implementation of corrective action plans
Compile data, provide feedback, and generate reports for operations and/or training areas on quality performance
Train new employees and remains current with all guideline changes, work instructions, etc. Write or assist in writing desk procedures and training materials for departments
Provide assistance with special projects such as testing for new business implementation or system changes, review change requests, interpret department workload, statistical reports, assist co-workers, etc
To Qualify for This Position, You'll Need:
A High School Diploma or equivalent
1 year of related claims processing, customer service, auditing, training, analysis or operations experience
2 years of experience performing quality audits
Strong analytical, presentation, customer service, persuasion, and organization skills
Strong business math proficiency
The ability to document problems and assist in their resolution
The ability to document processes and identify areas for improvement
Strong written and verbal communication skills
Knowledge of Microsoft Office applications
We Prefer You to Have:
Previous Quality Assurance Analyst experience
What Blue Can Do for You :
Our comprehensive benefits package includes:
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
On-site cafeterias and fitness centers in major locations
Wellness programs and a healthy lifestyle premium discount
Tuition assistance
Service recognition
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 our 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.
We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.
Some states have required notifications. Here's more information.
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 minorities, females, disabled individuals and 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 physical and mental disabilities.
If you need special assistance or an accommodation while seeking employment, please e-mail mycareer.help@bcbssc.com or call 1-800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.
Position
Purpose
We are currently hiring for a Senior Quality Assurance Analyst-PGBA to join BlueCross BlueShield of South Carolina. In this role as a Senior Quality Assurance Analyst-PGBA, you will be responsible for performing quality control audits to evaluate accuracy and effectiveness 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.
Here is your opportunity to join a dynamic team at a diverse company with secure, community roots and an innovative future.
Logistics :
This position is full-time (40 hours/week, 8 hours/day) Monday - Friday in a typical office environment. This role is located onsite in Florence, SC.
What You'll Do:Conduct focused quality audits across various operations functions to ensure quality standards, procedures, and methodologies are being followed
Document findings of analysis and prepare recommendations for implantation of new systems, procedures, or organizational changes to reduce errors
Identify areas of weakness and communicate recommendations on changes and improvements to training materials
Provide feedback to management on errors detected, ensure errors are resolved, and provide long-range solutions to causes
Develop and implement a quality control and improvement program based on targets identified through the quality reviews. Monitor and evaluate the implementation of corrective action plans
Compile data, provide feedback, and generate reports for operations and/or training areas on quality performance
Train new employees and remains current with all guideline changes, work instructions, etc. Write or assist in writing desk procedures and training materials for departments
Provide assistance with special projects such as testing for new business implementation or system changes, review change requests, interpret department workload, statistical reports, assist co-workers, etc
To Qualify for This Position, You'll Need:
A High School Diploma or equivalent
1 year of related claims processing, customer service, auditing, training, analysis or operations experience
2 years of experience performing quality audits
Strong analytical, presentation, customer service, persuasion, and organization skills
Strong business math proficiency
The ability to document problems and assist in their resolution
The ability to document processes and identify areas for improvement
Strong written and verbal communication skills
Knowledge of Microsoft Office applications
We Prefer You to Have:
Previous Quality Assurance Analyst experience
What Blue Can Do for You :
Our comprehensive benefits package includes:
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
On-site cafeterias and fitness centers in major locations
Wellness programs and a healthy lifestyle premium discount
Tuition assistance
Service recognition
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 our 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.
We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.
Some states have required notifications. Here's more information.
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 minorities, females, disabled individuals and 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 physical and mental disabilities.
If you need special assistance or an accommodation while seeking employment, please e-mail mycareer.help@bcbssc.com or call 1-800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.