Compliance Quality Assurance Specialist

Compliance Quality Assurance Specialist

Candidate Authenticity Statement We recognize that AI tools are increasingly used in professional settings. However, during our assessment and interview process, we ask candidates to complete all responses independently, without the use of AI-generated assistance. This ensures we can accurately assess your individual skills, communication style, and problem-solving approach. Submissions or responses that appear AI-generated may be considered misaligned with our evaluation standards.

Remote-First with In-Person Training: This position is remote following successful completion of onboarding. New hires are required to attend two weeks of in-person training at our Carrollton, TX corporate office to ensure a smooth and successful transition into the role.

Position Summary: The Compliance Quality Assurance Specialist is responsible for auditing and reviewing services and processes across all departments to ensure compliance with company and government regulations while maintaining quality standards. This role involves conducting daily audits, analyzing results, and providing feedback for process improvements, ensuring transparency and accountability in all quality assurance activities.

Principal Duties & Responsibilities:

• Account Review: Review of NCA's (New Client Applications) and renewing client accounts, ensuring that their plans are set up in compliance with IRS regulations, HIPAA regulations and Dept. of Labor regulations. (Advanced)
• COBRA: Various COBRA responsibilities, including the review of, and any changes to, Qualified Beneficiaries and Special Plan Members accounts, as well as ensuring accuracy of COBRA Plan and Rates setup. (Intermediate)
• Call Scoring: Call monitoring to ensure accurate information is provided to our customers as well as making sure that our Participant Service representatives are providing the best possible experience. (Intermediate)
• Peer Review: Daily Peer QA, by reviewing a sampling of each team member's work, so that you as the individual, as well as the team as a whole, can meet/exceed our individual/team accuracy of 98%. (Intermediate)
• SOP and Document Review: Periodic review of our current processes and procedures and updating of our existing documentation and SOP's when necessary. (Advanced)
• Audits and Projects: Working on various audits and projects when necessary and completing them within the set parameters of the audit or project in question. (Advanced)
• Other Duties: Daily assignment of a variety of work items, typically assigned throughout the day as the workload comes in while maintaining the team's daily goals and turnaround times. (Intermediate)