Easy JobQuality Specialist II
Premera Blue Cross · Worldwide · Full-time · Remote
Workforce Classification:
TelecommuterJoin Our Team: Do Meaningful Work and Improve People’s Lives
Our purpose, to improve customers’ lives by making healthcare work better, is far from ordinary. And so are our employees. Working at Premera means you have the opportunity to drive real change by transforming healthcare.
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Join the Provider Contact Center Quality Program as a Quality Specialist II and help shape quality across our offshore operations. You’ll partner with teams to identify opportunities, strengthen quality practices, and drive improvements that make a measurable difference. The Quality Specialist II is responsible for overseeing Premera's compliance with corporate audit programs such as the Blue Cross Blue Shield Association (BCBSA) Member Touchpoint Measures (MTM) and Licensee Desk Level Audit (LDLA) and the Federal Employee Program (FEP) audit, along with ensuring compliance with state and federal laws, contracts and the achievement of corporate objectives. The Quality Specialist II performs daily examination and verification of Premera transactions, such as claims processing, customer inquiries, group and member enrollment and electronic data exchange. The Quality Specialist II monitors all quality standards for selected claims, inquiries, enrollments and/or electronic transactions for accuracy, completeness and timeliness to judge the degree of adherence to the criteria set forth by the BCBSA, FEP and corporate poli