Supervisor, Quality Assurance

BlueCross BlueShield of South Carolina•Columbia, SC

2d•Hybrid

About The Position

Summary Provides supervision of staff performing quality control activities for department or line business. Description Logistics: National Alliance – one of BlueCross BlueShield's South Carolina subsidiary companies. Location: This hybrid position is full-time (40-hours/week) Monday-Friday in a typical office environment. You will work an 8-hour shift scheduled during our normal business hours of 8:00AM-5:00PM. This role is located at 4101 Percival Road, Columbia, SC 29229. What You’ll Do: Supervises staff in conducting timely quality control audits for one or more of the following functions; claims, customer service inquiries, membership, coordination of benefits, refunds, billing, etc. May also supervise staff in completing special projects including system changes. Mediates and negotiates staff conflicts, makes hiring, disciplinary and performance decisions and sets department goals or standards. Determines training priorities and coordinates internal training activities as needed. Identifies and recommends procedural enhancements to improve quality and minimize financial loss to the corporation. Prepares and reviews reports and analyses providing interpretation of production and quality standards. Maintains and updates desk procedures to ensure quality and minimize processing errors.

Requirements

Bachelor's degree. Degree Equivalency: 4-years job related work experience OR Associate's and 2-years job related work experience
3-years of experience performing quality audits, including 1-year of related claims processing, customer service, auditing, training, analysis or operations experience.
Conducts audits
Prepares summary reports
Demonstrates strong proficiency in math
Maintains quality improvement process
Writes reports of audit findings

Responsibilities

Supervises staff in conducting timely quality control audits for one or more of the following functions; claims, customer service inquiries, membership, coordination of benefits, refunds, billing, etc.
May also supervise staff in completing special projects including system changes.
Mediates and negotiates staff conflicts, makes hiring, disciplinary and performance decisions and sets department goals or standards.
Determines training priorities and coordinates internal training activities as needed.
Identifies and recommends procedural enhancements to improve quality and minimize financial loss to the corporation.
Prepares and reviews reports and analyses providing interpretation of production and quality standards.
Maintains and updates desk procedures to ensure quality and minimize processing errors.