Sr Insurance Operations Quality Assurance Specialist
Horace Mann
WorldwideFully remoteFull TimeSeniorHealthcare & Telemedicine
USD 57,500–71,900 a yearPosted 13 hours ago13h agoApply link checked 10 hours ago
Why we think you can apply
- Hiring model
- Open worldwide · the employer states no country restriction
- Work from
- Anywhere, the UAE included
Posted 13 hours ago · apply link checked 10 hours ago
About the role
Responsibilities
- Conduct daily quality audits for assigned departments
- Evaluate work for accuracy, completeness, and compliance with company policies and regulatory requirements
- Perform audits across Claims, Customer Service, New Business, Underwriting, and Policy Services
- Conduct comprehensive audits of Supplemental Health claims, including complex and high-risk cases
- Interpret and apply policy provisions, benefit requirements, and limitations
- Identify processing errors, recurring trends, and root causes for operational improvement
- Assist with the development and refinement of Quality Audit programs
- Provide feedback to leadership regarding audit findings and departmental performance
Requirements
- High School Diploma or GED
- 3+ years of health claims experience
- Strong understanding of claims processing workflows and Supplemental Health claim administration
- Ability to interpret policy provisions, benefit requirements, limitations, and exclusions
- Exceptional attention to detail and strong analytical and critical-thinking skills
- Ability to evaluate complex information and exercise sound judgment
- Strong written and verbal communication skills
Preferred Qualifications
- Previous Quality Audit or Quality Assurance experience
- Experience auditing complex Supplemental Health claims
- Experience providing technical guidance, training, or calibration support
About the Company
Horace Mann was founded in 1945 by two Springfield, Illinois, teachers who saw a need for quality, affordable auto insurance for teachers. We serve more than 4,100 school districts nationwide and help educators protect what they have today and prepare for a successful tomorrow.
What we look for
- High School Diploma or GED
- 3+ years of health claims experience
- Understanding of claims processing workflows
- Ability to interpret policy provisions
- Strong analytical skills
- Strong communication skills
OperationsQuality AssuranceInsurance
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Horace Mann
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NeverApply scores every new listing against your CV, salary floor and visa. A handful of real matches by morning.
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