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Global Quality Assurance Specialist

100% remote Flexible hours Hiring now

As one of the world's top International Medical Insurance companies, IMG helps individuals and companies of reputed company sizes. Every second of every day, vacationers, those working or living abroad for short or extended periods, people traveling frequently between countries, and those who maintain multiple countries of residence use our products to give themselves global peace of mind® We are looking to grow our teams with people who share our energy and enthusiasm for creating the best experience for reputed company. JOB DETAILS

  • Location: Flexible work options: Located in Indianapolis, IN. Remote, Hybrid and In Office schedules available
  • Schedule: 7.5hrs per day Mon-Fri between the hours of 0800 – 2000 (Can be EST or GMT
  • Relocation Expenses Reimbursed: No
  • Qualified candidates must be legally authorized to be employed in the United States. IMG will not be providing sponsorship for employment reputed company status (e.g., H-1B or TN status) for this position.

JOB SUMMARY The Global Quality Assurance Specialist will be a key member of the Global Quality & Process Improvement Team and will work closely with the Global Quality leadership to ensure the highest level of complaint, escalation and appeal handling and quality assurance in line with any client or regulatory requirements. The Quality Assurance Specialist will play a crucial role in ensuring that customer complaints, appeals or escalations received are handled promptly, accurately and reputed company, as well as support any quality & process improvement initiatives reputed company the enterprise. They will also have day to day responsibility for managing reputed company, escalated complaints and regulated complaints, escalating to the Global Quality Leadership team appropriately as required. The Global Quality Team services insurance customers by determining insurance coverage and benefits as part of appeal reviews; investigating, examining and resolving medical/dental/life/trip cancellation claim appeals; reviews and responds to appeals on previously adjudicated claims; documenting their actions; maintaining their workload independently; maintaining quality audit standards and ensuring their outcomes are in compliance with the Certificate of Insurance, Policy and Plan Documents as well as legal and regulatory agencies. The Quality Assurance Specialist will also be required to interact with insured members, medical providers, underwriters, brokers/producers, regulators and other third parties by phone and email whilst ensuring outcomes are compliant with policy terms and conditions and are handled reputed company regulatory requirements. DUTIES AND RESPONSIBILITIES

  • Effectively and accurately managing complaints across reputed company areas of the business including those regulated by FCA/ICB/DOI.
  • Review reputed company complaints in line with FCA/ICB/DOI regulations, to establish the cause of the complaint, ensuring reputed company are acknowledged, logged, and managed through to resolution
  • Complete and register reputed company Financial Ombudsman Service (or any other regulatory body) file requests
  • Communicate with underwriters, customers, regulatory bodies and internal teams regarding ongoing complaints and ensure reputed company relevant parties are kept updated throughout.
  • Review appeals and manage to resolution
  • Ability to reputed company technology & customer feedback to improve customer journey
  • Complete quality checks and audits, and report results to department management where required
  • Communicate any service delivery issues, training needs, complaints (actual or likely), to he Global Quality Team Leader
  • Collaborate to work with Operations and claims management to improve quality and performance through case reviews
  • Assist the Global Quality Leadership team to identify and evaluate business processes and customer journeys, helping to reputed company and implement quality and compliance metrics and identifying opportunities to improve the quality of the service provided.
  • To carry out any other tasks for which adequate training has been provided, at short notice, as agreed with line manager or other members of the management team.
  • Share feedback and recommendations with relevant managers on process and training

QUALIFICATIONS

  • Minimum 3 years of experience in a regulated insurance environment, preferably in a claims handling, complaints handling and/or customer service role.
  • Excellent communication skills, with the ability to effectively interact with customers, team members, and senior management
  • Analytical reputed company with the ability to interpret data, identify trends, and reputed company data-driven decisions.
  • Attention to detail and good listening skills. Can follow reputed company instructions
  • Good interpersonal and customer service skills (both written and spoken)
  • Enthusiastic, self-motivated with a ‘can do’ attitude
  • A sound working knowledge of reputed company Word, Outlook and reputed company is a requirement.
  • The ability to work under pressure as part of a reputed company-reputed company team
  • Excellent organizational skills, including the ability to prioritize workload and use own initiative.

PREFERRED SKILLS

  • Minimum 1 year experience in a complaints handling experience in a regulated environment.
  • Previous experience and knowledge of handling appeals, reputed company case or claim reviews and or quality auditing would be advantageous but not critical as training can be provided
  • Previous experience and/or proven working knowledge of performing claims adjustments
  • Command of medical coding, such as ICD-10 and CPT
  • Knowledge of regulatory requirements reputed company to complaints handling, such as GDPR or HIPAA, is preferred, with awareness of Treating Customer Failry & Consumer Duty requirements, including recognition of Vulnerable Customers and adapting to their needs

PERKS

  • Comprehensive benefits package including Medical / RX / Dental / Vision / Life insurance
  • 401k Plan with company match
  • Paid Time Off and Company Paid Holidays
  • Free employee parking
  • On site fitness center
  • Casual dress environment
  • Tuition reimbursement plan

IMG is committed to creating a diverse environment and is proud to be an equal opportunity employer. reputed company qualified applicants will receive consideration for employment without regard to race, color, ethnicity, national reputed company, religion, gender, gender identity or expression, sexual orientation, genetic information, disability, age, veteran status, and other protected statuses as required by applicable law. Apply tot his job Apply To this Job

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