Quality Assurance Analyst

About the role

Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina and much more. We are one of the nation's leading administrators of government contracts, operate one of the most sophisticated data processing centers in the Southeast, and have a diverse family of subsidiary companies that allows us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team! This role is located at 17 Technology Cir., Columbia, SC 29209.

Responsibilities

• 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.

Requirements

• High School Diploma or equivalent
• 1 year of related claims processing, customer service, auditing, training, analysis, or operations experience
• Good analytical, customer service, and organization skills
• Basic business math proficiency
• Able to document problems and assist in their resolution
• Able to document processes and identify areas for improvement
• Effective written and verbal communication skills
• Proficiency with Microsoft Office

Qualifications

• 1 year of experience in the healthcare or insurance industry (preferred)

Benefits

• Eligibility for benefits program 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

Schedule

Full‑time, 40 hours per week, Monday‑Friday. 8‑hour shift during normal business hours (8:00 AM‑5:00 PM); occasional overtime may be required.