Medicare Compliance – QA Associate

November 25

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Spark

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Insurance • SaaS

Spark is a modern platform that revolutionizes the insurance brokerage industry by providing cutting-edge technology and expert services. It aims to enhance broker productivity, streamline operations, and accelerate agency growth. Spark offers a comprehensive suite of tools, including business reporting, contracting, licensing, marketing, and customer service support, particularly focusing on Medicare. Through strategic partnerships, Spark helps brokerages scale efficiently, ensuring unparalleled visibility and insights into business operations.

51 - 200 employees

☁️ SaaS

📋 Description

• Manage the complete lifecycle of compliance cases, including intake, investigation, communication, resolution, and formal closure. • Maintain accurate case records in the case management system and ensure timely documentation of notes, evidence, and required follow-up actions. • Act as the primary liaison with agents, agencies, internal teams, and carriers to ensure clear and timely communication throughout the case process. • Monitor case progress, send reminders, and escalate issues as needed to prevent delays and mitigate compliance risks. • Ensure all necessary information is provided to carriers and verify that all steps are completed before closing cases to support audit readiness. • Provide targeted coaching and guidance to agents on compliance requirements, documentation standards, and best practices based on identified risks or performance gaps. • Educate agents on policies, procedures, and necessary corrective actions aligned with case findings. • Identify recurring compliance issues and escalate trends to leadership for broader coaching or training initiatives. • Assist agents and agencies with carrier compliance audits and provide preparation support. • Support agents in navigating carrier portals through self-service guides and direct assistance. • Maintain records of coaching participation, track completion metrics, and flag gaps requiring follow-up. • Maintain organized, accurate, and audit-ready records for all compliance interactions and case activities. • Assist with preparing reports, summaries, dashboards, or data extracts related to compliance cases, agent performance, and key compliance indicators. • Collaborate with the compliance team on special projects, process improvements, and the development or refinement of new workflows. • Support additional compliance-related requests assigned by leadership, ensuring flexibility and responsiveness to priorities. • Remain agile and adaptable in the continually evolving Medicare regulatory landscape, adjusting processes and support practices as standards change.

🎯 Requirements

• Strong organizational skills with the ability to manage multiple tasks and cases accurately and efficiently. • Clear and professional written and verbal communication skills for working with agents, carriers, and internal teams. • Ability to quickly learn Medicare and compliance concepts and explain them to agents in simple, actionable terms. • High attention to detail for documentation, case notes, and recordkeeping. • Basic analytical skills to review data, identify simple trends, and support compliance monitoring. • Ability to follow structured workflows, processes, and guidelines consistently. • Strong judgment, professionalism, and discretion when handling sensitive or confidential information. • Prior exposure to Medicare, health insurance, regulatory compliance, customer support, or operations (Nice-to-Have). • Familiarity with quality assurance reviews, call evaluations, or enrollment processes (telephonic or field-based) (Nice-to-Have).

🏖️ Benefits

• Equity compensation • Health care, including dental and vision through our PEO Sequoia • Flexible work location; co-working available • 401k • Paid Time Off • Monthly Remote Work Stipend (help cover costs of home-office needs) • Paid Parental Leave • Up to 14 weeks for birthing parents • Up to 8 weeks for non-birth parents • 11 paid holidays • 2 week sabbatical at 5 years of employment • Wellbeing Perks through SpringHealth, OneMedical, PerkSpot, and SoFi