Analyst, Quality Assurance

Full-time - Entry Level

Florence, SC

Religious, Grantmaking, Civic, Professional, and Similar Organizations

About the position

We are currently hiring for a Quality Assurance Analyst, to join BlueCross BlueShield of South Carolina. In this role as a Quality Assurance Analyst, under direct supervision, perform quality control audits, review, or monitor departmental operation functions including, but not limited to, claims, membership, customer service/call center, workflow, processing support systems, procedures, documentation, etc. Identify problems, analyze cause and effect, and make recommendations for improvements. Here is your opportunity to join a dynamic team at a diverse company with secure, community roots and an innovative future.

Responsibilities

• 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
• 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

Requirements

• Required Education: High School Diploma OR equivalent
• 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
• Effective written and verbal communication skills
• Strong business math proficiency

Nice-to-haves

• 1 year of experience in a healthcare or insurance industry

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