Senior Quality Assurance Analyst - PGBA (Surfside)Why should you join the BlueCross BlueShield of South Carolina family of companies? We are the largest insurance company in South Carolina and one of the nation's leading administrators of government contracts. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team!
Job Purpose: Performs quality control audits to evaluate accuracy and effectiveness of departmental operations functions including claims, membership, benefit files, customer service/call center, and processing support systems. Identifies problems, analyzes cause and effect, and makes recommendations for improvements.
Logistics: This position is full-time (40 hours/week) Monday – Friday, located onsite at 8733 Highway 17 Bypass in Myrtle Beach, SC.
***Current C2/TRICARE Security Clearance required or ability to obtain one*** What You'll Do: Conduct focused quality audits across various operations functions to ensure quality standards, procedures, and methodologies are being followed. Document findings of analysis and prepare recommendations for new systems, procedures, or organizational changes to reduce errors.Identify areas of weakness and communicate recommendations on changes and improvements to training materials. Provide feedback to management on errors detected and ensure errors are resolved.Compile data, provide feedback, and generate reports for operations and/or training areas on quality performance. Train new employees and remain current with all guideline changes.Provide assistance with special projects such as testing for new business implementation or system changes.To Qualify for This Position, You'll Need: Required Education: A 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 Skills and Abilities: Strong analytical, presentation, customer service, persuasion, and organization skills.Strong business math proficiency.Ability to document problems and assist in their resolution.Strong written and verbal communication skills.Knowledge of Microsoft Office applications.We Prefer You to Have: Strong proficiency with Excel and Access.Prior experience with PGBA.Knowledge of BlueCross systems such as CMMS.What Blue Can Do for You: 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 a healthy lifestyle premium discount.Tuition assistance.Service recognition.What to Expect Next: After submitting your application, our recruiting team 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.
Management will conduct interviews with those candidates who qualify, with prioritization given to those who demonstrate the preferred qualifications.
We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.
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