Quality Assurance, Risk Control & Special Investigations Analyst
New
B
BestowInsurance Operations
Remote, USFull-TimeMiddle
Salary$26 – $30 per hour • Offers Equity
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Job Details
- Experience
- Minimum of 2 years
- Required Skills
- ComplianceQuality Assurance
Requirements
- Minimum of 2 years of professional experience in Quality Assurance (QA), Compliance, Fraud Analysis, or an operational role within the life insurance, financial services, or TPA industry.
- Strong working knowledge of life insurance policy lifecycle, administrative forms, and general TPA operating procedures.
- Proven ability to analyze complex transaction histories, identify unusual patterns, and draw sound conclusions for risk and fraud assessment.
- Exceptional verbal and written communication skills.
- Ability to deliver difficult feedback constructively.
- Ability to concisely summarize investigation findings for executive review.
- Experience with a formal quality monitoring system (e.g., call recording, QA software) preferred.
- Familiarity with state and federal regulations governing life insurance (e.g., anti-money laundering, privacy) preferred.
- Experience in conducting internal control audits (SOX, SOC) preferred.
- Experience creating quality assurance checklists within QA systems preferred.
Responsibilities
- Conduct comprehensive quality audits of inbound and outbound call center interactions for accuracy and regulatory compliance.
- Review and audit service and administrative forms for completeness and proper processing.
- Deliver objective, constructive feedback and coaching to call center agents and team leads.
- Act as the initial point of contact for internal fraud referrals (SIU) and analyze cases flagged for potential fraudulent activity.
- Gather, summarize, and maintain confidential documentation and system history for suspicious cases.
- Prepare and present well-documented case files for formal referral to the carrier’s Special Investigations Unit.
- Execute periodic monitoring of key operational and financial controls within the TPA environment.
- Collaborate with Operations and Training teams to develop process enhancements and compliance training modules.
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