Analyst, Senior Quality Assurance

BlueCross BlueShield of South Carolina•Columbia, SC

1d•Hybrid

About The Position

Summary Performs 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 Location: This hybrid position is full-time (40-hours/week) Monday-Friday in a typical office environment. You will work an 8-hour shift scheduled during our normal business hours of 8:00AM-4:30PM. This role is located at 4101 Percival Road, Columbia, SC 29229. What You’ll Do: Conducts focused quality audits across various operations functions to ensure quality standards, procedures, and methodologies are being followed. Documents findings of analysis and prepares recommendations for implementation of new systems, procedures, or organizational changes to reduce errors. Identifies areas of weakness and communicates recommendations on changes and improvements to training materials. Provides feedback to management on errors detected, ensures errors are resolved, and provides long-range solutions to causes. Develops and implements a quality control and improvement program based on targets identified through the quality reviews. Monitors and evaluates the implementation of corrective action plans. Compiles data, provides feedback, and generates reports for operations and/or training areas on quality performance. Trains new employees and remains current with all guideline changes, work instructions, etc. Writes or assists in writing desk procedures and training materials for departments. Provides assistance with special projects such as testing for new business implementation or system changes, reviewing change requests, interpreting department workload, statistical reports, assisting co-workers, etc.

Requirements

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.
Advanced knowledge of Microsoft Office.
Strong analytical, presentation, customer service, persuasion, and organization skills.
Strong business math proficiency.
Ability to document problems and assist in their resolution.
Ability to document processes and identify areas for improvement.
Strong written and verbal communication skills.

Responsibilities

Conducts focused quality audits across various operations functions to ensure quality standards, procedures, and methodologies are being followed.
Documents findings of analysis and prepares recommendations for implementation of new systems, procedures, or organizational changes to reduce errors.
Identifies areas of weakness and communicates recommendations on changes and improvements to training materials.
Provides feedback to management on errors detected, ensures errors are resolved, and provides long-range solutions to causes.
Develops and implements a quality control and improvement program based on targets identified through the quality reviews.
Monitors and evaluates the implementation of corrective action plans.
Compiles data, provides feedback, and generates reports for operations and/or training areas on quality performance.
Trains new employees and remains current with all guideline changes, work instructions, etc.
Writes or assists in writing desk procedures and training materials for departments.
Provides assistance with special projects such as testing for new business implementation or system changes, reviewing change requests, interpreting department workload, statistical reports, assisting co-workers, etc.