Quality Specialist II

Premera Blue Cross

. Conduct audits using and interpreting applicable standards and requirements .

Posted 10/28/2026full-timeRemote • United StatesMid-LevelSenior💰 $48,400 - $72,600 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in conducting audits, interpreting standards, and developing audit reports while effectively communicating findings and recommendations. Proficient in quality assurance principles and capable of leading team initiatives to enhance operational procedures.

Highest-signal resume keywords

Quality Audit ExperienceClaims ProcessingBilingual Proficiency (English/Spanish)Quality 101 CertificationAudit Reporting

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Audit TechniquesQuality ControlQuality AssuranceResource SchedulingTrend AnalysisRoot Cause IdentificationCorrective Action EvaluationDocumentationKeyboarding SkillsProcedural Improvement

Soft Skills

Clear CommunicationConflict ResolutionTeam LeadershipFacilitation SkillsInterpersonal Skills

Certifications & Qualifications

Quality 101 Certification

Industry Keywords

Quality ReviewQuality Assurance IssuesOperational GuidelinesAudit StandardsCustomer Service Experience

About the role

Key responsibilities & impact

Conduct audits using and interpreting applicable standards and requirements
Plan, develop, and communicate audits within a defined scope, including resource scheduling
Conduct meetings required for audit performance
Maintain working knowledge of procedural changes, audit techniques, automated systems, subsystems, and reference materials
Verify, document, and communicate audit results
Develop audit reports and evaluate corrective actions and follow-up
Resolve audit findings and conflicts directly and respectfully
Identify trends and root causes of errors
Recommend improved procedures and guidelines to Operations
Consult with external departments on high-impact quality assurance issues
Participate in, lead, and facilitate team meetings and work groups concerning Quality Review & Reporting initiatives and incentives
Explain quality principles and align the audit function with organizational objectives
Perform other duties as assigned

Requirements

What you’ll need

High school diploma or GED (Required)
Three (3) years of claims, customer service or enrollment work experience, including one (1) year of quality audit, quality control, or quality assurance experience (Required)
Bilingual proficiency in a particular language (English/Spanish) may be required (Preferred)
Quality 101 certification (Preferred)
Ability to keyboard
Ability to communicate clearly and understandably in person and over the telephone
Ability to perform essential physical requirements with or without accommodation

Benefits

Comp & perks

Medical, vision, and dental coverage with low employee premiums
Voluntary benefit offerings, including pet insurance
Life and disability insurance
Retirement programs, including a 401K employer match and a pension plan vested after 3 years of service
Wellness incentives, including mental well-being resources, counseling services, stress management programs, and mindfulness programs
Generous paid time off
Tuition assistance for undergraduate and graduate degrees
Employee recognition program
Commuter perks
Free convenient on-site parking
Subsidized on-campus cafes
On-site health and wellness activities
Fitness and well-being center with in-person and virtual workouts and nutritional counseling
Shuffleboard and ping pong on campus