Quality Assurance Associate Auditor – Dentaquest
| Company | Sun Life |
|---|---|
| Location | Nashville, TN, USA, Milwaukee, WI, USA, Kansas City, MO, USA, Needham, MA, USA, Hartford, CT, USA, Portland, ME, USA, Baltimore, MD, USA |
| Salary | $54000 – $72900 |
| Type | Full-Time |
| Degrees | Bachelor’s |
| Experience Level | Junior, Mid Level |
Requirements
- Two to four year College Degree in Finance or Healthcare preferred; High School diploma/GED Required.
- Two or more years of Customer Service experience in health care industry, preferably in an auditing role.
- Strong customer service business, operational and procedural knowledge.
- Ability to identify prevalent adverse performance trends and recommend resolution techniques to management.
- Maintain a comprehensive working knowledge of policies and procedures across all product lines. Ability to make sound decisions.
- Ability to examine and solve problems.
- Strong written and oral communication skills.
- Proven reasoning and reasoning skills that apply methods of consistency, validity, soundness and completeness.
- In depth knowledge of Windward a plus.
- Strong computer skills. Intermediate to Advanced knowledge of Microsoft Excel, Access and Word required.
- Ability to work overtime as needed or required.
Responsibilities
- Monitor call quality using assessment tools; score and document results for each monitored call.
- Identify prevalent trends and recommend immediate resolution techniques to management.
- Provide quality feedback to representatives and to Customer Service Supervisors.
- Identify additional training needs based on review and evaluation of quality monitoring results.
- Adhere to Interrater Reliability principles to ensure the audit results generated meet the accepted criteria by quantitatively defining the degree of agreement between two or more auditors.
- Share ideas/recommendations for process improvements for monitoring and training with management team.
- Develop and coordinate the implementation of systems, procedures and forms to improve data collection.
- Assist in the development of action plans to address quality deficiencies.
- Develop and update quality templates with current review elements.
Preferred Qualifications
- Spanish speaking skills preferred.