Job Type Full-time Description Come Smile with Us! Do you have an eye for detail, a passion for compliance and a commitment to exceptional quality service? Delta Dental of Iowa invites applications for Quality Assurance Analyst to conduct routine and ad-hoc quality assurance audits/reviews of key functions, high-risk and/or complex transactions to ensure actions are timely, accurate, efficient and adhere to company policies, industry standards, regulatory requirements, and contract terms. You will partner with cross functional teams to identify issues, streamline processses and implement solutions that drive operational excellence. Join our collaborative environment, where your contributions make a real impact on the health and smiles of the people we serve! Learn from Jennifer what it is like to work at Delta Dental of Iowa. Why Delta Dental of Iowa?For your smile. For your health. For your community. At Delta Dental of Iowa, we're more than just a dental and vision insurance company. Improving health and wellness is at the center of everything we do. As a not-for-profit, we aim to build stronger communities by investing in actions that promote and improve health. Delta Dental of Iowa invests 40% of our dollars directly back into the communities we serve. Come see why we are passionate about Bringing Smiles to our customers. Our team enjoys competitive pay and benefits, an awesome One Team approach, and a company culture that fosters Exceptional Quality Service and Leadership at All Levels. Together, we can make a difference - not only in Iowa but across the country. Essential Functions and Principal Accountabilities:
- Develop and conduct routine quality assurance reviews of key functions and high-risk and/or complex transactions to ensure compliance with the company's policies and procedures, internal standards, federal and state laws, and contract terms.
- Assist with oversight and administer compliance-related activities, when needed.
- Develop new quality assurance review procedures that test the internal controls of key risks associated with each functional area and/or transaction.
- Develop and conduct ad-hoc audits/reviews as needed.
- Develop and work exception reports and/or queries to monitor issues or concerns.
- Partner with functional areas to determine the root cause of issues and help develop action plans to address the issues.
- Create reporting formats and report findings in a timely and accurate manner.
- Track and follow-up on the status of all open issues to ensure action plans are implemented in the most effective and efficient manner. Document and report the status on a regular basis.
- Support Compliance department with third-party audits and exams by responding to inquiries and/or fulfilling requests.
- Foster mutually beneficial relationships with all functional areas by continually acting as a partner and resource to the area and staff.
Requirements
Bachelor's degree in related field or equivalent work experience. 2-4 years' experience, in a related role, including but not limited to, quality assurance, internal audit, information technology business analyst or test analyst, compliance, or 5 years in benefit administration in the dental or healthcare insurance industry. Clear and concise writing and presentation skills. Excellent interpersonal, analytical, and communication skills. Proficient skills and experience using Microsoft Office applications such as Word, Excel, and Power-Point. Self-directed with ability to work independently and as part of a team to achieve goals and objectives. Demonstrated ability to prioritize, organize, and function effectively with multiple tasks/assignments. Knowledge of the laws and regulations applicable to the dental/health insurance industry such as Coordination of Benefits, ERISA, HIPAA, Affordable Care Act ( ACA ), Medicare Advantage, and/or Medicaid, etc., preferred. Knowledge of and/or experience using various formal or informal audit/testing protocols, methodologies, techniques, and tools, preferred. Experienced using Business Objects or similar data querying tools, preferred. Delta Dental of Iowa is an Affirmative Action and Equal Opportunity Employer committed to providing equal employment opportunity for all persons without unlawful regard of race, color, religion, sex, sexual orientation, gender identity, age, national origin, individuals with disabilities, protected veteran status, or any other legally protected basis. EEOC Poster