Senior Quality Assurance Analyst

BlueCross BlueShield of South Carolina • Columbia, SC

1d • Hybrid

About The Position

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 role is full time M-F 8am-5pm. The first 3 months of training will be onsite with ability to be hybrid at our Columbia, SC location after. What You Will 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 Train 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
• Microsoft Office
• Strong analytical, presentation, customer service, persuasion, and organization 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.

Nice To Haves

• Call center experience
• Healthcare industry knowledge

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
• Train 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.

Benefits

• 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 healthy lifestyle premium discount
• Tuition assistance
• Service recognition
• Incentive Plan
• Merit Plan
• Continuing education funds for additional certifications and certification renewal

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED