Quality Assurance Specialist Ii - Reston, United States - CareFirst BlueCross BlueShield

CareFirst BlueCross BlueShield

Verified Company

Reston, United States

3 weeks ago

Posted by:

Mark Lane

beBee recruiter

Description

Resp & Qualifications

PURPOSE:

ESSENTIAL FUNCTIONS:

Audits assigned function (service, claims, enrollment) for accuracy, benefit payment, contract interpretation, and compliance with policies and procedures. Identifies, documents and reports transaction errors utilizing departmental quality monitoring templates in a timely manner to ensure prompt resolution.
Conducts structured coaching and feedback sessions. Provides feedback and recommends improvement action plans for areas of deficiency within the group or for an individual.
Participates in the creation and implementation of new methods, processes and/or products. Prepares reports and submits them to manager. Assists in development of special department projects and participates in divisional projects.

QUALIFICATIONS:

Education Level:
High School Diploma or GED

Experience: 5 years Auditing, Quality Assurance, Operations, Training, Project Management or comparable work experience

Knowledge, Skills and Abilities (KSAs)

Knowledge of quality assurance and production technologies.
Proficient in Microsoft Office programs.
Knowledge of industry standards, quality control techniques and procedures.
Excellent communication skills both written and verbal.
Excellent research and organizational skills.
Strong Interpersonal skills.
Extensive analytical and problemsolving skills. Must be able to effectively work in a fastpaced environment with frequently changing priorities, deadlines, and workloads that can be variable for long periods of time. Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.

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Salary Range:$45,072 - $82,632

Salary Range Disclaimer

Department
Enrollment Business Area - Quality

Equal Employment Opportunity
CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer.

It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Where To Apply

Federal Disc/Physical Demand

Note:

The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.

PHYSICAL DEMANDS:

The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.

Sponsorship in US
Must be eligible to work in the U.S. without Sponsorship