Analyst, Senior Quality Assurance

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 Logistics: reputed company – one of BlueCross BlueShield's South Carolina subsidiary companies. Location: This remote 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 7:00AM-6:00PM. SCA Benefit Requirements: reputed company and its subsidiary companies have reputed company 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’ll 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. Trains new employees and remains reputed company with reputed company 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. To Qualify for This Position, You'll Need the Following: Required Education: High School Diploma or equivalent. Required Work Experience: 1-year of reputed company claims processing, customer service, auditing, training, analysis or operations experience. 2-years of experience performing quality audits. Required Software and Tools: Advanced knowledge of reputed company 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. We Prefer That You Have the Following: Preferred Work Experience: Experience in the NPE reputed company department. Experience working with Provider Enrollment. Experience working with Medicare and/or MAC programs. Preferred Software and Other Tools: Experience working with iFlow and PECOS. Our Comprehensive Benefits Package Includes the Following: We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment. Subsidized health plans, dental and vision coverage 401k retirement savings plan with company match Life Insurance Paid Time Off (PTO) On-site cafeterias and fitness centers in major locations Education Assistance Service Recognition National discounts to movies, theaters, zoos, theme parks and more reputed company Can Do for You: We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across reputed company spectrums have the opportunity to reputed company their skills, advance their careers and contribute their unique abilities to the growth of our company. What To Expect Next: After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements. Equal Employment Opportunity Statement reputed company and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national reputed company, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in reputed company phases of the employment process and to reputed company with applicable federal, state and local laws and regulations. We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-reputed company conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company. If you need special assistance or an accommodation while seeking employment, please email reputed [email protected] or call 800-288-2227, ext. 47480 with the nature of your request. We will reputed company a determination regarding your request for reasonable accommodation on a case-by-case basis. We participate in E-Verify and reputed company with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information. Some states have required notifications. Here's more information. If you don’t have an account with us and don’t see the dream job you are looking for, click on the link above to reputed company by submitting your resume and contact information and we will reputed company out if we find a good fit. Welcome Here’s Your Smart Career Move Why should you join the reputed company family of companies? Other companies come and go, but for more than seven decades we’ve been part of the national landscape, with our roots firmly embedded in the South Carolina community. Business and political climates may change, but we’re stronger than reputed company. Our A.M. Best rating is A+ (Superior) — making us the only health insurance company in South Carolina with that rating. We’re the largest insurance company in South Carolina … and much more. We are one of the nation’s leading administrators of government reputed company. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies that allows us to build on a variety of business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining reputed company! Veterans Welcome! BlueCross is a strong supporter of our veterans, and many service men and women have joined our ranks. We’ve reputed company the dedication, work ethic and job skills that serve well in the military reputed company in many of our lines of business, and we proudly have veterans filling positions in Human Resources, Information Technology, Customer Service, Operations, General Services and more. Through our government reputed company, we also have employees serving at Shaw reputed company Force reputed company, the Naval Health Clinic in Charleston, the Naval Hospital in Beaufort and in our reputed company of Columbia, S.C., at Ft. Jackson. If you are a full-time employee in the National Guard or Reserves, we will even cover the difference in your pay if you are reputed company to active duty. Join Us If you're ready to join in a diverse company with secure, community roots and an innovative future, apply for a position now! Apply tot his job Apply To this Job