Fraud Quality Control Officer I

Overview

Reports to: Fraud Strategy & Analytics Manager

Functions Supervised: None

Primary Functions: Perform quality control reviews and testing of the Fraud Operations and Dispute Resolution pillars. Conduct sample alert/case reviews for policy and procedure compliance, to include but not limited to decision quality, loss mitigation, case resolution, and regulatory compliance. Perform quality control reviews on member interactions to ensure top-tier member service and respond to consumer complaints. 

Duties and Responsibilities:

Qualifications

Education:  High school graduate or equivalent.

Creditable Experience in Lieu of Education: Not Applicable

Experience/Skills: Prior experience in Quality Control, Quality Assurance, Compliance Testing, or Auditing preferred. Knowledge of quality control tools, statistical analysis, and root cause analysis desired. Proactive team member with a demonstrated ability to identify and address challenges, while consistently earning the trust and collaboration of colleagues, employees, members, and external partners. Must have strong oral and written communication skills, and general knowledge of financial transactions. Demonstrates skill in creating high-quality presentations and reports using the full suite of Microsoft tools such as Word, Excel, PowerPoint, and Visio. Demonstrates proficiency in interpreting and implementing regulations and procedures during case evaluations, while consistently upholding objectivity and autonomy. Ability to work independently with strong problem-solving and de-escalation skills required.

Tenure:Assignment to the Fraud Quality Control Officer I (Category 10), or Fraud Quality Control Officer II (Category 09) position will be determined by the candidate's education and/or experience. Advancement requires management recommendation and will be based on the candidate's experience and performance.

Compensation

Starting base salary will be determined based on candidate experience, qualifications, education, and applicable local or state wage requirements, and will fall within the range provided below. In accordance with our Salary Administration policy, new hire base salaries generally fall between the minimum and midpoint of the listed range.

Salary Pay Range: 09

Salary Pay Range: 10

Benefits

• Short-term and long-term incentives
• Comprehensive medical, dental and vision insurance plan that has HSA and FSA options
• 401(k) plan with a 5% match
• Employee Assistance Program (EAP)
• Life and disability coverage
• Voluntary cash benefits for accident, hospitalization and critical illness
• Tuition Reimbursement
• Generous leave programs to include Paid Time Off accrual, Paid Sick Leave, Paid Holidays
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Equal Opportunity Employer

Salary : $63,233 - $112,677