Quality Assurance Specialist

3 days ago

Remote, Oregon, United States Exact Medicare Full time $65,000 - $85,000 per year

About Exact Medicare

Company Overview

At Exact Medicare, we are committed to creating a superior client experience by understanding and caring for our customers so well that they would never think about leaving us—and want to tell everyone about us Our team members are empowered by our core values, which drive everything we do.

Our Core Values

  • Extreme Ownership: We take ownership of our actions and responsibilities, delivering the best possible results for our clients.
  • Above Reproach: We uphold the highest standards of integrity and ethics in all interactions and decisions.
  • Culture of Candor: We foster a culture of open and honest communication, valuing ideas and feedback to continuously improve.
  • Atomic Growth: We are committed to continuous personal and organizational growth to better serve our clients and community.

Position Summary:

The Quality Assurance (QA) Specialist is responsible for monitoring, evaluating, and documenting the quality and compliance of Medicare sales and service calls to ensure adherence to CMS, carrier, and internal regulatory standards. This role supports the company's compliance goals by identifying trends, providing accurate audit feedback, and collaborating with management to enhance agent performance and maintain operational integrity.

Key Responsibilities:

  • Review and evaluate inbound and outbound Medicare sales calls for accuracy, compliance, and professionalism.
  • Ensure all required disclaimers, needs analyses, plan presentations, and enrollment verifications follow CMS and carrier guidelines.
  • Accurately complete QA scorecards and document findings with supporting evidence.
  • Identify compliance risks, trends, and agent coaching opportunities.
  • Partner with the QA Manager, trainers, and leadership to deliver feedback and performance improvement recommendations.
  • Participate in calibration sessions to maintain scoring consistency and alignment across the QA team.
  • Contribute to process and script improvement initiatives by sharing data-driven insights.
  • Maintain confidentiality and compliance with company and CMS data protection standards.

Qualifications:

  • 2+ years of experience in Quality Assurance, Compliance, or Call Auditing (Medicare or insurance experience preferred).
  • Strong knowledge of Medicare Advantage, Part D, and related compliance requirements is a plus.
  • Excellent analytical, listening, and communication skills.
  • High attention to detail and accuracy in documentation.
  • Ability to provide constructive feedback in a professional and supportive manner.
  • Proficient in Microsoft Office Suite, Google Workspace, and QA monitoring platforms.
  • Ability to work independently and meet daily audit targets in a fast-paced environment.

Core Competencies:

  • Integrity and Compliance Focus
  • Analytical and Critical Thinking
  • Communication and Feedback Skills
  • Accuracy and Attention to Detail
  • Collaboration and Teamwork
  • Confidentiality and Professionalism

If you are a licensed, highly motivated individual who shares our core values, has a passion for helping Medicare-eligible seniors, and a drive for sales success, we encourage you to apply and become part of the Exact Medicare team

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