full-timeColumbia

Summary

Location

Columbia

Type

full-time

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About this role


Summary
 

Under direct supervision, performs quality control audits, reviews, or monitoring 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 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-4:30PM. It may be necessary, given the business need to work occasional overtime. This role is located at 4101 Percival Road, Columbia, SC 29229.

What You’ll Do:

  • 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. May provide one on one guidance to new hires upon completion of initial training.

  • 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.

To Qualify for This Position, You'll Need the Following:

  • Required Education: High School Diploma or equivalent

  • Required Work Experience: 1-year of related claims processing, customer service, auditing, training, analysis, or operations experience.

  • Required Skills and Abilities:

    • Good analytical, customer service, and organization skills.

    • Basic business math proficiency.

    • Ability to document problems and assist in their resolution.

    • Ability to document processes and identify areas for improvement.

    • Effective written and verbal communication skills.

  • Required Software and Other Tools: Knowledge of Microsoft Office.

We Prefer That You Have the Following:

  • 1-year of experience in the healthcare or insurance industry.

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

What We Can Do for You:

We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop 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

BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, 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 all phases of the employment process and to comply 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-related 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 [email protected] or call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.

We participate in E-Verify and comply 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

Other facts

Tech stack
Analytical Skills,Customer Service,Organization Skills,Business Math Proficiency,Documentation,Communication Skills

About BlueCross BlueShield of South Carolina

For more than six decades, BlueCross BlueShield of South Carolina has been part of the national landscape. Our roots are firmly embedded in the state. We are the largest insurance company in South Carolina. We are also the only one that has an A+ Superior A.M. Best rating. We are one of the nation's leading government contract administrators. We operate one of the most sophisticated data processing centers in the Southeast and have a diverse family of subsidiary companies.

Our full-time employees enjoy benefits like a 401(k) retirement savings plan with company match, subsidized health plans, free vision coverage, life insurance, paid annual leave and holidays, wellness programs and education assistance. If you are a full-time employee in the National Guard or reserves, we will cover the difference in your pay if you are called to active duty. BlueCross has a dedicated corporate culture of community support. Our employees are some of the most giving in the country. They support dozens of nonprofit organizations every year.

If you're ready to join a diverse company with secure, community roots and an innovative future, apply for a position now!

BlueCross BlueShield of South Carolina is an independent licensee of the Blue Cross and Blue Shield Association.

We are an Equal Opportunity Employer. We will consider all qualified applicants for employment regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information, or any other legally protected status.

Team size: 10,001+ employees
LinkedIn: Visit
Industry: Insurance
Founding Year: 1946

What you'll do

  • The Quality Assurance Analyst performs quality control audits and monitoring of departmental operations to ensure adherence to quality standards. They identify problems, analyze causes, and recommend improvements based on their findings.

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Frequently Asked Questions

What does a Quality Assurance Analyst do at BlueCross BlueShield of South Carolina?

As a Quality Assurance Analyst at BlueCross BlueShield of South Carolina, you will: the Quality Assurance Analyst performs quality control audits and monitoring of departmental operations to ensure adherence to quality standards. They identify problems, analyze causes, and recommend improvements based on their findings..

Why join BlueCross BlueShield of South Carolina as a Quality Assurance Analyst?

BlueCross BlueShield of South Carolina is a leading Insurance company.

Is the Quality Assurance Analyst position at BlueCross BlueShield of South Carolina remote?

The Quality Assurance Analyst position at BlueCross BlueShield of South Carolina is based in Columbia, South Carolina, United States. Contact the company through Clera for specific work arrangement details.

How do I apply for the Quality Assurance Analyst position at BlueCross BlueShield of South Carolina?

You can apply for the Quality Assurance Analyst position at BlueCross BlueShield of South Carolina directly through Clera. Click the "Apply Now" button above to start your application. Clera's AI-powered platform will help match your profile with this opportunity and guide you through the application process. You can also learn more about BlueCross BlueShield of South Carolina on their website.