Quality Assurance Officers

Our purpose, to improve customers’ lives by making healthcare work better, is far from ordinary. Working at Premera means you have the opportunity to drive real change by transforming healthcare.
By investing in our employees and fostering a culture of collaboration and continuous development, we’re able to better serve our customers. Learn how Premera supports our members, customers and the communities that we serve through our Healthsource blog: .
The Audit Specialist III provides audit feedback for customer service and claims associates to help meet Company goals. This position will audit and review select processes and procedures such as claims inquiries and enrollment transactions to ensure accuracy and improve performance. Incumbents will conduct audits for assigned areas to monitor, document, and trend results. They will also provide suggestions for management on plan improvement and will help provide effective coaching to associates.
Review and make available a variety of audit reference materials and data, including case reviews, bulletins, programs, brochures, memos, and spreadsheets.
Audit team and individual associates' calls and sample items such as, enrollments, claims, or inquiries for transaction compliance, accuracy, completeness, and timeliness.
Complete trending and root cause analysis to reduce errors and improve behaviors. Review data to make recommendations on policy and procedural revisions.
Provide consistent feedback, question support, and training for associates to help implement changes that will result in efficiencies and reduce errors. Conduct both new hire training and cross training of existing associates as needed to support the business.
Complete special projects and perform other duties as assigned.
Two (2) years of customer service, claims or membership and billing experience in a call center, healthcare, or insurance environment. (Two (2) years of experience in training or audit functions. (Experience with Premera's technical platforms. (Experience with call monitoring software. (Skills operating computer in a Windows environment, including Visio, Access and Power point and Internet (DSHS, OIC regulations, HCFA, Public use files, etc.). (Project management experience. (Quality 101 certified. (Advanced auditing and quality assurance experience.
Stronger data analysis and root cause skills.
Experience coaching and training associates.
Opportunities to improve policies and workflows.
Broader knowledge of healthcare operations and compliance.
The following have been identified as essential physical requirements of this job and must be performed with or without an accommodation: This role requires the ability to keyboard and to communicate clearly and understandably in person, and over the telephone.

Our comprehensive total rewards package provides support, resources, and opportunities to help employees thrive and grow. Our total rewards are more than a collection of perks, they're a reflection of our commitment to your health and well-being. We offer a broad array of rewards including physical, financial, emotional, and community benefits, including:
Medical, vision, and dental coverage with low employee premiums.
Life and disability insurance.
Retirement programs, including a 401K employer match and, believe it or not, a pension plan that is vested after 3 years of service.
We have tuition assistance for both undergraduate and graduate degrees.
For our hybrid employees, our on-campus model provides flexibility to create your own routine with access to on-site resources, networking opportunities, and team engagement.
Free convenient on-site parking.
Participate in engaging on-site activities such as health and wellness events, coffee connects, disaster preparedness fairs and more.
Our complementary fitness & well-being center offers both in-person and virtual workouts and nutritional counseling.
Challenge someone to a game of shuffleboard or ping pong while on campus.
Premera seeks to attract and retain the most qualified individuals without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, gender or gender identity, sexual orientation, genetic information or any other protected characteristic under applicable law.
If you need an accommodation to apply online for positions at Premera, please contact Premera Human Resources via email at View email address on click.appcast.io or via phone at View phone number on click.appcast.io.
we generally target up to and around the midpoint of the range.