$Not specified
The QA Specialist reviews and evaluates Medicare sales calls for compliance and professionalism. They document findings, identify trends, and collaborate with management to enhance agent performance.
Candidates should have 2+ years of experience in Quality Assurance or Compliance, preferably in Medicare or insurance. Strong analytical and communication skills, along with attention to detail, are essential.
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!
This job posting was last updated on 10/15/2025