The role of an Insurance Quality Assurance Specialist involves monitoring organizational procedures to ensure compliance with guidelines and regulations, while also providing coaching to employees, and reporting to management. Determines non-compliant operations, documents details and follows up that corrective action has been taken. Analyzes operating procedures to devise most efficient methods of accomplishing work.
Essential Duties and Responsibilities
Supporting organizational studies, evaluating problems, gathering information, analyzing data, and communicating findings to improve operational efficiency and effectiveness while ensuring compliance and proposing improvements.
Tasks include handling customer complaints related to the Distribution Unit, supporting management in process design, performing testing and validation, and maintaining updated procedures while complying with established due dates for self assessments reports and Units Quality Reviews.
This role involves ensuring compliance with laws, regulations, and policies, as well as evaluating business operations to identify potential issues and proposing corrective actions by organizing and documenting observations and determining the root cause of issues.
Communicates results of targeted reviews and corrective action plan validations in an objective and unbiased manner, reflecting relevant facts that lead to logical conclusions.
Considers available solutions to propose remediation plans for Management to develop and implement appropriate corrective actions.
Maintains an understanding of Insurance Operations and applicable regulatory and corporate policy guidance/expectations.
Serve as a team leader and acts independently working under limited supervision.
Education
Bachelor’s degree in Business Administration, Information Systems, Mathematics, Statistics or Programming.
Experience
At least two years of related experience.
Other Qualifications
Experience in auditing, validating, or quality review analyst.
Knowledge of Insurance Operation.
Customer Focus.
Ability to identify problems, analyze their causes and resolve them in a timely and successful way. manner to reduce time and facilitate work processes in the unit.
Capacity to work in teams and collaborate with peers to meet common goals.
Analytical and quantitative capacity.
Ability to work with multiple tasks simultaneously and under pressure.
Ability to organize and administrative time in an efficient manner to meet required deadlines.
Knowledge in statistics and presentation programs: MS Excel, Power-BI, Power Point, Word and Outlook.
Oral and written proficiency in both English and Spanish.
Region Locations
Corporate Office Park 001, Guaynabo, PR
Values
Passion for PeopleSucceed TogetherOwn Every MomentBuild the Future
Additional Requirements
Job Segment: QA, Compliance, Law, Quality, Legal, Customer Service
