Senior Insurance Operations Quality Assurance Specialist

Location: Remote

Salary: $57,500–$71,900 annually plus bonus; compensation depends on experience and location.

Company

hirify.global is a publicly traded insurance and financial services company serving more than 4,100 school districts nationwide and specializing in products for educators.

What you will do

• Conduct daily, ad hoc, and special quality audits across Claims, Customer Service, New Business, Underwriting, and Policy Services.
• Audit complex, high-risk, and non-routine Supplemental Health claims from initial review through final disposition.
• Interpret policy provisions, benefit requirements, limitations, exclusions, and plan language when evaluating claim decisions.
• Document audit findings, identify inconsistencies and missing documentation, and analyze trends and root causes.
• Partner with operational leaders to recommend corrective actions and improve quality, consistency, compliance, and customer outcomes.
• Support quality program development, auditor training, coaching, calibration exercises, and technical guidance.

Requirements

• High School Diploma or GED.
• At least 3 years of health claims experience.
• Strong understanding of claims processing workflows and Supplemental Health claim administration.
• Ability to interpret policy provisions, benefit requirements, limitations, and exclusions.
• Exceptional attention to detail, analytical and critical-thinking skills, sound judgment, and ability to evaluate complex information.
• Strong written and verbal communication skills.

Nice to have

• Previous Quality Audit or Quality Assurance experience.
• Experience auditing complex Supplemental Health claims.
• Experience providing technical guidance, training, or calibration support.

Culture & Benefits

• Remote work arrangement.
• Bonus eligibility in addition to the stated annual salary range.
• Opportunity to support insurance and financial products designed for educators.
• Equal employment opportunity for qualified applicants.