Senior Quality Review and Audit Analyst, Individual Dental Operations

This is a fully remote position, open to applicants in Missouri, +2 more states.

📋 Description

• Perform quality assessments and audits of customer engagements, operational transactions, and related system activities.

• Assess work in accordance with procedures, quality benchmarks, scoring criteria, business mandates, and regulatory standards.

• Oversee designated audits from the selection of cases and evidence evaluation to scoring, documentation, and finalization.

• Keep precise audit records that support scores, findings, and conclusions.

• Evaluate audit findings to pinpoint recurring mistakes, quality patterns, process deficiencies, and operational risks.

• Create summaries of audit results and preliminary analyses for Quality Assurance leadership.

• Contribute to ongoing quality and audit reporting efforts.

• Engage in internal and vendor calibration meetings.

• Act as a knowledgeable technical resource and assist less-experienced team members.

• Support onboarding and job-shadowing initiatives.

• Identify shortcomings in procedures, workflows, systems, training, and audit guidelines.

• Aid quality-enhancement projects, corrective measures, process modifications, and validation efforts.

• Collaborate with Operations, Compliance, vendor partners, and cross-functional teams to investigate findings and resolve quality issues.

• Clearly present audit findings to business and vendor partners.

• Assist in technical troubleshooting and escalate incidents when system issues impede audit completion or accuracy.

• Carry out Lead Analyst backup tasks as assigned.

⛳️ Requirements

• A minimum of three years of relevant experience in healthcare operations, customer service, benefits, eligibility, claims, contact center operations, quality assurance, or auditing.

• Previous experience in conducting quality assessments, operational audits, transaction reviews, or similar control activities.

• Proven ability to autonomously carry out both routine and complex audit tasks.

• Experience in consistently applying audit criteria, scoring guidelines, procedures, and business requirements.

• Capability to identify patterns and convey findings with clear examples and supporting evidence.

• Strong analytical, problem-solving, and decision-making abilities.

• Excellent attention to detail and a commitment to precise audit documentation.

• Ability to juggle multiple tasks and priorities in a fast-paced setting.

• Strong written and verbal communication skills.

• Ability to provide technical support and guidance without formal supervisory authority.

• Proficiency in Microsoft Office applications, especially Microsoft Excel.

• Ability to work collaboratively with internal teams, business partners, and vendor organizations.

• For remote work, a cable broadband or fiber optic internet connection with a minimum of 10Mbps download/5Mbps upload speed is required.

🏝️ Benefits

• Eligibility for an annual bonus plan.

• Medical, vision, and dental benefits begin on day one.

• Access to well-being and behavioral health programs.

• 401(k) plan.

• Company-sponsored life insurance.

• Tuition reimbursement opportunities.

• At least 18 days of paid time off each year.

• Paid holidays.

• Leave of absence options.

• Flexible remote work arrangements.