Senior Quality Assurance Analyst

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.

This role is full time M-F 8am-5pm, onsite at our Myrtle Beach, SC location. Government Clearance:
This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen. SCA Benefit Requirements:
Blue Cross Blue Shield of South Carolina and its subsidiary companies have contracts 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.

• 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
• Train new employees and remains current with all 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.

• Required
  
  Education:
  
  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 Software and tools:
  Microsoft 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.

• 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 healthy lifestyle premium discount
• Tuition assistance
• Service recognition Incentive Plan Merit Plan
• Continuing education funds for additional certifications and certification renewal

Welcome Here’s Your Smart Career Move Why should you join the Blue Cross Blue Shield of South Carolina 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 ever. 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 contracts. 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…