Role OverviewThe Quality Assurance, Risk Control & Special Investigations Analyst is a specialized and critical role responsible for ensuring operational integrity, service excellence, and adherence to regulatory standards across our life insurance Third-Party Administrator (TPA) operations. This individual performs three key functions: auditing call and service interactions, conducting pre-referral fraud investigations while providing supporting documentation regarding alleged fraud inquiries, and monitoring internal controls to drive process improvement and mitigate risk.
What You Will Do
Conduct comprehensive quality audits of inbound and outbound call center interactions, review and audit completed service and administrative forms, deliver timely and objective feedback and coaching to call center agents and team leads, track and analyze key TPA and QA metrics, and conduct preliminary analysis to determine the validity of fraud concerns.
Why It Might Be a Fit
This role requires a 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, with strong working knowledge of life insurance policy lifecycle, administrative forms, and general TPA operating procedures.
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
- Experience with a formal quality monitoring system (e.g., call recording, QA software)
- Familiarity with state and federal regulations governing life insurance (e.g., anti-money laundering, privacy)
- Experience in conducting internal control audits (SOX, SOC)
- Experience creating quality assurance checklists within QA systems
Benefits
- Competitive salary
- Equity based on role
- Flexible paid time off
- Parental leave programs
- 100% paid-premium option for medical, dental, and vision insurance
- Lifestyle stipend
- Flexible work-from-home policy
- Employee-led diversity, equity, and inclusion initiatives
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