Quality Examiner – PIO

The PIO Quality team at BlueCross BlueShield of Tennessee is hiring a Quality Examiner.

We’re looking for someone with PIO experience (current or within the last 2 years) to sample work done by various areas in the PIO division. This person will be responsible for ensuring work was handled appropriately and according to MTM/LOS and internal guidelines.

Note: This role may require some overtime.

Job Responsibilities

• Disseminating quality information to keep staff informed of guidelines, policies and procedures.
• Proactively identify error trends; recognizing and identifying when procedures need to be changed or developed.
• Maintaining accurate and timely documentation pertaining to individual quality evaluations.
• Participating in defining quality issues and determining approaches and methodology for addressing these issues.
• Work overtime as required

Job Qualifications

Education

• High School Diploma or equivalent

Experience

• 1 year – Applicable system experience (Facets, etc.)
• 2 years – Operations experience required

Skills\Certifications

• Must have proficient knowledge in one or more functions being audited
• Proficient in Microsoft Office (Outlook, Word, Excel and Powerpoint)
• Proficient oral and written communication skills
• Proficient interpersonal and organizational skills
• Exceptional time management skills
• Ability to work independently under general supervision and collaboratively as part of a team in a fast paced environment
• Independent, Sound decision-making and problem-solving skills
• Capacity to solve problems and manage multiple assignments with critical deadlines
• Capability to handle large volumes of work
• If current employee with the company, must meet minimum performance expectations
• Current or previous PIO experience preferred.

Company:

BCBST BlueCross BlueShield of Tennessee, Inc.

Applying for this job indicates your acknowledgement and understanding of the following statements:

BCBST is an Equal Opportunity employer (EEO), and all employees and applicants will be entitled to equal employment opportunities when employment decisions are made. BCBST will take affirmative action to recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law.