Senior Quality Assurance Analyst

BlueCross BlueShield of South Carolina•Florence, SC

2d•Onsite

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 role is full time M-F 8am-5pm, onsite at our Florence, SC location. Government Clearance: This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen. SCA Benefit Requirements: BlueCross BlueShield of South Carolina and its subsidiary companies have contracts with the federal government subject to the Service Contract Act (SCA). Under the McNamara-O'Hara Service Contract Act (SCA), employees cannot opt out of health benefits. Employees will receive supplemental pay until they are enrolled in health benefits 28 days after the hire date. 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

Required Education: High School Diploma OR equivalent
Required Work Experience: 1 year of related claims processing, customer service, auditing, training, analysis or operations experience.
2 years of experience performing quality audits
Required Software and tools: Microsoft Office
Required Skills and Abilities: 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.

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