Quality Assurance Customer Service Associate Auditor, DentaQuest

Sun Life • Kansas City, WI

20d • $54,000 - $72,900 • Hybrid

About The Position

Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide. Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities. DentaQuest manages dental and vision benefits for more than 33 million Americans. Our outcomes-based, cost-effective solutions are designed for Medicaid and CHIP, Medicare Advantage, small and large businesses, and individuals. With a focus on prevention and value, we aim to make quality care accessible to improve the oral health of all. Job Description: Location: Sun Life embraces a hybrid work model that balances in-office collaboration with the flexibility of virtual work. Our team members and leaders are expected to foster connection and teamwork by being present in the office at least 2 days per week. The opportunity: The Quality Assurance Customer Service Associate Auditor performs quality monitoring of live and/or recorded calls to ensure department quality objectives are achieved with the established frequency of audits. Skills of each Customer Service Representative will be evaluated against established phone quality metrics, which include but are not limited to, accuracy of information provided, tone of representative, effective call management and demonstrated professionalism.

Requirements

• Two to four year College Degree in Finance or Healthcare preferred.
• High School diploma/GED Required.
• 2 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 inspect and solve problems.
• Strong written and oral communication skills.
• Proven judgement 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.

Nice To Haves

• Spanish speaking skills preferred.
• In depth knowledge of Windward a plus.

Responsibilities

• Performs quality monitoring of live and/or recorded calls to ensure department quality objectives are achieved with the established frequency of audits.
• Skills of each Customer Service representative will be evaluated against established phone quality metrics, which include but are not limited to, accuracy of information provided, tone of representative, effective call management and demonstrated professionalism.
• 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 element

Benefits

• At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program.
• Plan for your future with our 401(k) employer match, stock purchase options and an employer-funded retirement account.
• Enjoy a flexible, inclusive and collaborative work environment that supports career growth.
• We’re proud to be recognized in our communities as a top employer.
• Proudly Great Place to Work® Certified in Canada and the U.S., we’ve also been recognized as a "Top 10" employer by the Boston Globe's "Top Places to Work" for two years in a row.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED