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Quality Assurance Analyst

Spectraforce Technologies
United States, South Carolina, Columbia
Mar 03, 2025
Role Name: Quality Assurance Analyst Location: Columbia, SC 29229 Work Environment: Onsite Schedule: Monday-Friday 8:30am - 4:30pm Contract length: 3 months assignment with possible conversion Job Summary: Duties/About the role: Under direct supervision, performs quality control audits, reviews, or monitoring 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. Day to Day: 50% 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. 20% 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. 20% 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. 10% Assists with training documentation and development of new processes and procedures. Remains current with all guidelines, work instructions, etc. Work environment: Typical office environment. Team Info: Team consists of three areas-Audit, Refund, Quality Control and comprised of 12 people, our teams work on claims investigation, workflow activities, and audits. Any extra/additional job info: NA Job Requirements: Required Experience: 1 year of related claims processing, customer service, auditing, training, analysis, or operations experience. Required EDU: High School Diploma or equivalent. Required Certification or licenses:NA Required Software and Tools (Hands on experience required): Microsoft Office Soft skills: communication skills Nice to have/Preferred skills:1 year-of experience in a healthcare or insurance industry. Languages: English