Global Quality Assurance Specialist

As one of the world's top International Medical Insurance companies, IMG helps individuals and companies of all 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 mindu00ae We are looking to grow our teams with people who share our energy and enthusiasm for creating the best experience for travelers.u00a0 u00a0 JOB DETAILS + Location:u00a0 Flexible work options:u00a0Located in Indianapolis, IN. Remote andu00a0Hybrid schedulesu00a0available + Schedule: Mon-Fri between the hours of 0800 - 2000u00a0 + Relocation Expenses Reimbursed:u00a0 No + Qualified candidates must be legally authorized to be employed in the United States. IMG will not beu00a0providing sponsorship for employment visa status (e.g., H-1B or TN status) for this position. u00a0 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 efficiently, as well as support any quality & process improvement initiatives within the enterprise. They will also have day to day responsibility for managing complex, 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.u00a0 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 within regulatory requirements.u00a0 u00a0 u00a0 DUTIES AND RESPONSIBILITIES + Assist the Quality Team Leader with complaint handling across all business regulated by FCA/ICB/DOI regulations. + Review all complaints in line with FCA/ICB/DOI regulations, to establish the cause of the complaint, ensuring all are acknowledged, logged, and managed through to resolution + Complete and register all Financial Ombudsman Service (or any other regulatory body) file requests + Communicate with underwriters, customers, regulatory bodies internal teams regarding ongoing complaints and ensure all relevant parties are kept updated throughout. + Review appeals and manage to resolution + Ability to leverage technology & customer feedback to improve customer journey Full awareness of TCF & Consumer Duty requirements, including recognition of Vulnerable Customers and adapt to their needs + Communicate any service delivery issues, training needs, complaints (actual or likely), to department Managers + 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 u00a0 QUALIFICATIONSu00a0 + Minimum 3 year's experience in claims handling, claim audit, customer service or complaints handling role + Minimum of 5 yearsu2019 experience in an insurance or regulated environment + Excellent communication skills, with the ability to effectively interact with customers, team members, and senior management + Attention to detail and good listening skills. Can follow complex instructions + Good interpersonal and customer service skills (both written and spoken) + Enthusiastic, self-motivated with a u2018can dou2019 attitude + A sound working knowledge of Microsoft Word, Outlook and Excel is a requirement. + The ability to work under pressure as part of a close-knit team + Excellent organizational skills, including the ability to prioritize workload and use own initiative. u00a0 PREFERRED SKILLS + Previous complaints handling experience in a regulated environment. + Previous Appeals handling experience and knowledge advantageous but not critical as training can be provided + Assistance Case review experience is advantageous + Quality auditing experience preferred u2013 claims, case or call handling audit + Minimum (3) years of experience in Claims Examining + Previous experience and/or proven working knowledge of performing claims adjustments + Command of ICD-9 and ICD-10 or general claim coding practice + Analytical mindset with the ability to interpret data, identify trends, and make data-driven decisions + Knowledge of regulatory requirements related to complaints handling, such as GDPR or HIPAA u00a0 PERKS + Comprehensive benefits package including Medical / RX / Dental / Vision / Life insurance + 401k Plan with company match + Paid Time Off andu00a0Company Paid Holidays + Free employee parking + On site fitness center + Casual dress environment + Tuition reimbursement plan u00a0 IMG is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, ethnicity, national origin, religion, gender, gender identity or expression, sexual orientation, genetic information, disability, age, veteran status, and other protected statuses as required by applicable law. Powered by JazzHR

Created: 2026-04-27