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BlueCross BlueShield of South Carolina

Health insurance and plan administration

Senior Quality Assurance Analyst

Internal Audit & ControlsPosted on Nov 9
Full-timeFlorence, SC, USANo salary listed

About the Job

Requirements

  • A high school diploma or equivalent is required.
  • At least 1 year of related claims processing, customer service, auditing, training, analysis, or operations experience is required.
  • At least 2 years of experience performing quality audits is required.
  • Proficiency with Microsoft Office is required.
  • Strong analytical, presentation, customer service, persuasion, and organizational skills are required.
  • Strong business math proficiency is required.
  • Ability to document problems and assist in their resolution is required.
  • Ability to document processes and identify areas for improvement is required.
  • Strong written and verbal communication skills are required.
  • Applicants must be U.S. citizens and able to obtain a security clearance.

Responsibilities

  • Conduct focused quality audits across operations functions to ensure quality standards, procedures, and methodologies are followed.
  • Document analysis findings and prepare recommendations for implementing new systems, procedures, or organizational changes to reduce errors.
  • Identify areas of weakness and communicate recommendations for changes and improvements to training materials.
  • Provide feedback to management on detected errors, ensure errors are resolved, and provide long-range solutions to their causes.
  • Develop and implement a quality control and improvement program based on targets identified through 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 remain current with guideline changes and work instructions.
  • Write or assist in writing department desk procedures and training materials.
  • Assist with special projects such as testing new business implementations or system changes, reviewing change requests, interpreting department workload and statistical reports, and assisting coworkers.

About the Company

BlueCross BlueShield of South Carolina

Health insurance and plan administration

BlueCross BlueShield of South Carolina is a South Carolina-owned mutual health insurer and health-plan administrator. It offers individual, employer, Medicare and other coverage while operating provider networks, member services, claims and administrative programs. The organization also supports government and commercial health contracts through related businesses and specialized operations. This profile refers specifically to the South Carolina company, not the national Blue Cross Blue Shield Association, and centers on its role connecting members, employers, healthcare providers and public programs.

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