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Senior Quality Review and Audit Analyst, Individual Dental Operations
The Cigna Group. Conduct quality reviews and audits of customer interactions, operational transactions, and supporting system activity .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in conducting quality reviews and audits within healthcare operations, with a strong focus on compliance, documentation accuracy, and analytical problem-solving. Proficient in collaborating with internal teams and external partners to identify trends and improve operational processes.
Highest-signal resume keywords
Quality AssuranceOperational AuditsAnalytical SkillsMicrosoft Excel ProficiencyRegulatory Compliance
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Quality ReviewsAudit DocumentationScoring GuidelinesTransaction ReviewsProcess ImprovementData AnalysisEvidence ReviewAudit ReportingTechnical TroubleshootingIncident Escalation
Soft Skills
Attention to DetailProblem-SolvingDecision-MakingWritten CommunicationVerbal Communication
Tools & Technologies
Microsoft OfficeAudit Management Systems
Industry Keywords
Healthcare OperationsCustomer ServiceClaims ProcessingContact Center OperationsCompliance Standards
About the role
Key responsibilities & impact- Conduct quality reviews and audits of customer interactions, operational transactions, and supporting system activity
- Evaluate work against procedures, quality standards, scoring guidelines, business requirements, and regulatory expectations
- Manage routine and complex audits from case selection and evidence review through scoring, documentation, and completion
- Maintain audit records supporting scores, findings, and conclusions
- Support internal, vendor, regulatory, or third-party audit activities
- Analyze audit results to identify recurring errors, quality trends, process gaps, and operational risks
- Prepare audit summaries and initial analyses for Quality Assurance leadership
- Assist with recurring quality and audit reporting
- Participate in internal and vendor calibration sessions
- Serve as a technical resource for team members and support onboarding and job-shadowing
- Identify gaps in procedures, workflows, systems, training, and audit guidance
- Assist with quality-improvement projects, process changes, testing, and validation
- Work with Operations, Compliance, vendor partners, and matrix teams to research findings and address quality concerns
- Present audit results and supporting information to business and vendor partners
- Support technical troubleshooting and incident escalation when system issues affect audit completion or accuracy
Requirements
What you’ll need- Three or more years of relevant experience in healthcare operations, customer service, benefits, eligibility, claims, contact center operations, quality assurance, or auditing
- Previous experience conducting quality reviews, operational audits, transaction reviews, or comparable control activities
- Demonstrated ability to independently complete routine and complex audit assignments
- Experience applying audit criteria, scoring guidelines, procedures, and business requirements consistently
- Ability to identify trends and communicate findings using clear examples and supporting evidence
- Strong analytical, problem-solving, and decision-making skills
- Strong attention to detail and commitment to accurate audit documentation
- Ability to manage multiple assignments and priorities in a fast-paced environment
- Strong written and verbal communication skills
- Ability to provide technical support and guidance without formal supervisory authority
- Proficiency with Microsoft Office applications, particularly Microsoft Excel
- Ability to work collaboratively with internal teams, business partners, and vendor organizations
- If working at home occasionally or permanently, cable broadband or fiber optic internet service with at least 10Mbps download/5Mbps upload is required
Benefits
Comp & perks- Annual bonus plan eligibility
- Medical benefits
- Vision benefits
- Dental benefits
- Well-being and behavioral health programs
- 401(k)
- Company-paid life insurance
- Tuition reimbursement
- Minimum of 18 days of paid time off per year
- Paid holidays
- Leaves of absence