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Analyste, assurance de la qualité



Job Description

Express Scripts Canada is looking for an analytical individual to perform quality assurance reviews on dental audit reports within the Business Integrity department. The QA Analyst will also be responsible for performing and/or assisting with pre and post audit procedures for assigned on-site and desk audits including conducting occasional on-site dental audits.   The successful candidate will also provide training and guidance to fellow team members and be willing to occasionally travel throughout Canada including remote areas.  Using analytical and technical skills, the incumbent must be very detail oriented in identifying potential billing & reporting errors and initiate corrective action. This role will directly contribute to building a higher performance culture and living The Express Way values.
Essential Functions:
  • Review, verify and determine that audit reports performed adhere to customer plan designs and Provincial regulations.
  • Evaluate the accuracy of on- site audit reports which includes obtaining justifiable documentation and forming an objective opinion on the accuracy and legitimacy of claims audited. 
  • Assist with on-site/desk dental audits in order to correct risks identified and protect client assets.
  • Share QA results/feedback with the audit team to improve quality and efficiency of reports submitted to the customers.
  • Provides training and feedback to fellow team members to ensure consistency within the department.
  • Performs occasional on-site audits at dental offices across Canada to ensure dental providers have retained the appropriate documentation in support of the claims paid.  Findings from the audit will be documented in a detailed audit report. 
  • Communicate with providers and customers to ensure that service standards are met.
  • Assists with the quality assurance review of dental audit reports across the department utilizing a strong knowledge base of current dental regulations and fee guide codes, high attention to detail and accuracy.
  • Other tasks and duties as assigned.

  • Must have a diploma from a recognized post-secondary educational program in the dental services field either as a dental assistant or dental hygienist with a valid license; and At least 2 years of recent and demonstrated experience in a dental office environment
  • Experience in data analysis, financial analysis and report writing would be an asset
  • Strong knowledge of dental benefits and dental fee guides
  • Exceptional communication & analytical skills
  • Previous audit/investigation experience is preferred
  • Strong time management skills with the ability to work independently and in a team setting
  • Ability to work professionally with internal and external customers with a high attention to customer service
  • Proven ability to manage multiple high priority tasks in a fast-paced and constantly changing environment while meeting tight deadlines
  • Must be detail oriented
  • Excellent verbal and written communication skills
  • Ability to work independently and within a team environment
  • Proficient in computer applications (Word, Excel, PowerPoint)
  • Strong negotiation skills would be an asset

Contact Information

Posting Date: 14-Aug-2017Pharmacy Technicians/Assistants Permanent, Full-Time Open 1 ASAP
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