Senior Quality Assurance Analyst

260 CGS Administrators, LLC

Full-time - Entry Level

Remote

About the position

The Sr Quality Assurance Analyst at BlueCross BlueShield of South Carolina is responsible for performing quality control audits to assess the accuracy and effectiveness of various departmental operations functions. This role involves identifying problems, analyzing their causes, and recommending improvements to enhance operational efficiency. The position is remote and full-time, with a focus on ensuring quality standards are met across claims, membership, customer service, and other operational areas.

Responsibilities

• Conduct focused quality audits across various 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 weaknesses 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 on quality performance for operations and/or training areas
• Train new employees and remain current with all guideline changes, work instructions, etc.
• Write or assist in writing desk procedures and training materials for departments
• Assist with special projects such as testing for new business implementation or system changes, reviewing change requests, interpreting department workload, and statistical reports, assisting co-workers, etc.

Requirements

• High School Diploma OR equivalent
• One (1) year of related claims processing, customer service, auditing, training, analysis, or operations experience
• Two (2) years of experience performing quality audits
• 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

• 1-2 years auditing, claims processing, or customer service experience

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