Sr Insurance Operations Quality Assurance Specialist
Horace Mann is seeking an experienced and analytical Senior Insurance Operations Quality Assurance Specialist to help ensure quality, accuracy, and compliance across our Supplemental & Group operations.
In this role, you'll conduct comprehensive quality audits across operational areas while bringing deeper expertise to the review of Supplemental Health claims, including complex, high-risk, and non-routine cases. You'll analyze claim decisions from initial review through final disposition, interpret policy and benefit provisions, identify trends and root causes, and partner with operational leaders to strengthen quality and processes.
This is an excellent opportunity for an experienced health claims professional who enjoys digging into complex cases, identifying opportunities for improvement, and using their expertise to strengthen both individual and organizational performance.
Key Responsibilities
Quality Auditing & Analysis
- Conduct a designated number of daily quality audits for assigned departments.
- Evaluate work for accuracy, completeness, and compliance with company policies, procedures, and applicable regulatory requirements.
- Perform audits across operational areas including Claims, Customer Service, New B
