Quality Assurance Supervisor

Summary
 Why should you join the BlueCross BlueShield 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. We are 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 business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team!
Description
 

Job Purpose:

Provides supervision of staff performing quality control activities for department or line business.

Logistics:

This position is full-time (40 hours/week, 8 hours/day) Monday – Friday and is located at 4101 Percival Road in Columbia, SC. This position will require licensure from the South Carolina Department of Insurance within 90 days of date of hire.

What You'll Do:

• Supervise staff in conducting timely quality control audits for one or more of the following functions: claims, customer service inquiries, membership, coordination of benefits, refunds, billing, etc.
• May also supervise staff in completing special projects including system changes. Mediate and negotiate staff conflicts, make hiring, disciplinary and performance decisions and set department goals or standards.
• Determine training priorities and coordinate internal training activities as needed. Identify and recommend procedural enhancements to improve quality and minimize financial loss to the corporation.
• Prepare and review reports and analyses providing interpretation of production and quality standards.
• Maintain and update desk procedures to ensure quality and minimize processing errors.

To Qualify for This Position, You'll Need:

• A Bachelor's degree OR 4 years of job-related work experience OR
• An Associate’s degree AND 2 years of job-related work experience.
• 3 years of experience performing quality audits including 1 year of related claims processing, customer service, auditing, training, analysis or operations experience.
• Experience conducting audits.
• Experience preparing summary reports.
• The ability to demonstrate strong proficiency in math.
• The ability to maintain quality improvement processes.
• The ability to write reports of audit findings.
• Knowledge of Microsoft Office applications.

We Prefer You to Have:

• Experience with Excel and Access databases.
• Insurance experience with ACA and/or Medicare.
• Previous sales experience.

What Blue Can Do for You:

Our comprehensive benefits package includes:

• 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 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.

Management will be conducting interviews with those candidates who qualify, with prioritization given to those candidates who demonstrate the preferred qualifications.

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.

Some states have required notifications. Here's more information. 

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 minorities, females, disabled individuals and 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 physical and mental disabilities.

If you need special assistance or an accommodation while seeking employment, please e-mail [email protected] or call 1-800-288-2227, 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.