Senior Quality Review and Audit Analyst, Individual Dental Operations

This is a fully remote position, open to applicants in United States.

📋 Description

• Execute quality assessments and audits of customer engagements, operational transactions, and relevant system activities.

• Assess work in relation to established procedures, quality benchmarks, scoring guidelines, business specifications, and regulatory requirements.

• Oversee both routine and intricate audits from case selection and evidence assessment through scoring, documentation, and finalization.

• Preserve audit documentation that supports scores, findings, and conclusions.

• Facilitate internal, vendor, regulatory, or third-party audit initiatives.

• Examine audit outcomes to pinpoint recurring mistakes, quality patterns, process deficiencies, and operational hazards.

• Compile audit summaries and preliminary analyses for Quality Assurance leadership.

• Aid in regular quality and audit reporting tasks.

• Engage in internal and vendor calibration sessions.

• Act as a technical resource for team members while supporting onboarding and job shadowing processes.

• Detect shortcomings in procedures, processes, systems, training, and audit guidelines.

• Contribute to quality improvement initiatives, process alterations, testing, and validation efforts.

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

• Present audit findings and supporting materials to business and vendor partners.

• Assist in technical troubleshooting and incident escalation when system challenges impact audit execution or accuracy.

⛳️ Requirements

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

• Prior experience in conducting quality reviews, operational audits, transaction assessments, or similar control functions.

• Proven capability to independently execute both routine and complex audit tasks.

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

• Capacity to recognize trends and convey findings with clear examples and supporting documentation.

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

• Exceptional attention to detail and dedication to precise audit documentation.

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

• Excellent written and verbal communication skills.

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

• Proficiency in Microsoft Office applications, especially Microsoft Excel.

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

• If working from home occasionally or permanently, a cable broadband or fiber optic internet connection with at least 10Mbps download/5Mbps upload is necessary.

🏝️ Benefits

• Eligibility for an annual bonus plan.

• Medical coverage.

• Vision insurance.

• Dental coverage.

• Well-being and behavioral health initiatives.

• 401(k) plan.

• Company-provided life insurance.

• Tuition reimbursement program.

• A minimum of 18 days of paid time off annually.

• Paid holidays.

• Leaves of absence.