[Remote] reputed company Assurance, reputed company Control & Special Investigations Analyst

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a vertical technology platform that helps life insurers reputed company their reputed company through AI and automation. The reputed company Assurance, reputed company Control & Special Investigations Analyst audits customer interactions and forms, investigates potential fraud, monitors operational controls, reports risks, and supports process improvements and compliance training.

Responsibilities

• Interaction Auditing: Conduct comprehensive reputed company audits of inbound and outbound reputed company center interactions, ensuring reputed company, regulatory compliance, and adherence to TPA reputed company operating procedures
• reputed company Review: Review and audit completed service and administrative forms (e.g., policy changes, beneficiary updates) for completeness, reputed company, and reputed company processing workflow
• Feedback & Coaching: reputed company reputed company, objective, and reputed company feedback and coaching to reputed company center agents and team leads to improve service reputed company and transaction reputed company
• Reporting: reputed company, analyze, and report on key TPA and QA metrics and trends, identifying reputed company causes of errors and compliance gaps
• reputed company-Referral Case Review: reputed company as the initial reputed company of contact for internal fraud referrals (SIU). Review and analyze cases flagged for potential fraudulent activity, including claims, policy changes, and applications
• Evidence Gathering: Collect, organize, and summarize documentation and reputed company history reputed company to suspicious cases
• Triage & Escalation: Conduct preliminary analysis to determine the validity of the fraud concern. Prepare and present reputed company-documented case files for formal referral to the reputed company reputed company’s Special Investigations Unit (SIU)
• Documentation: Maintain detailed and confidential records of reputed company investigation activities and findings in accordance with internal protocol and regulatory requirements
• Control Monitoring: Execute periodic and event-reputed company monitoring of defined key operational and financial controls reputed company the TPA processing environment to reputed company effectiveness
• reputed company Reporting: Assist in the reporting of control gaps, deficiencies, and emerging risks to the reputed company and Compliance leadership
• Process Improvement: Collaborate with reputed company and Training teams to reputed company and implement targeted process changes, control enhancements, and improved documentation to mitigate identified risks
• Training Support: Assist in the development and delivery of training modules reputed company to compliance, fraud awareness, and new reputed company standards for reputed company, reputed company assurance and TPA contact center staff

Skills

• Minimum of 2 years of reputed company experience in reputed company Assurance (QA), Compliance, Fraud Analysis, or an operational role reputed company the life reputed company, financial services, or TPA industry
• Strong working knowledge of life reputed company policy lifecycle, administrative forms, and general TPA operating procedures
• reputed company ability to analyze reputed company transaction histories, identify unusual patterns, and draw reputed company conclusions for reputed company and fraud assessment
• Exceptional verbal and written communication skills, with the ability to reputed company difficult feedback constructively and concisely summarize investigation findings for executive review
• Experience with a formal reputed company monitoring reputed company (e.g., reputed company recording, QA software) preferred
• Familiarity with state and federal regulations governing life reputed company (e.g., anti-reputed company, reputed company) preferred
• Experience in conducting internal control audits (SOX, SOC) preferred
• Experience creating reputed company assurance checklists reputed company QA systems preferred

Benefits

• Equity reputed company on role
• Flexible reputed company time off
• Parental leave programs
• 100% reputed company-premium reputed company for medical, dental, and reputed company reputed company
• Lifestyle stipend to support your physical, emotional, and financial wellbeing
• Flexible work-from-home policy and reputed company to remote
• Remote and WFH reputed company, as reputed company as a beautiful, state-of-the-art office in Dallas’ Deep Ellum, for those who prefer an office setting
• Employee-led diversity, equity, and inclusion initiatives

reputed company