Product and Group Configuration Quality Specialist II

Telecommuter

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This is an exciting opportunity for an internal candidate to build on their knowledge of our business, systems, and customers while developing valuable expertise in product and group configuration quality. Join a collaborative team where your attention to detail, operational insight, and commitment to continuous improvement will help ensure benefits are configured accurately—and where you can grow from foundational audits into increasingly complex and influential work.

Product & Group Configuration Quality Specialist II will support accurate customer benefit delivery by performing foundational audits of product configuration and group setup across medical, dental, and pharmacy. The role will review configuration outputs against source documentation and established standards to identify discrepancies and ensure corrections are completed prior to downstream processing impacts. The position will contribute to quality and consistency by providing clear, actionable feedback and applying standard audit practices.

The role will focus on skill development through foundational audit work with progression to more complex audits as proficiency increases.

• Perform audits and testing of standard medical, dental, and pharmacy configuration work, including shells and entry-level final configurations, to verify alignment with source documentation and established processes.
• Analyze configuration outputs to confirm accuracy, completeness, and consistency prior to downstream processing.
• Deliver clear documentation of audit findings and required corrections to configuration partners.
• Support quality outcomes by providing timely, respectful, and actionable feedback that enables correction and learning.
• Analyze recurring issues and error patterns to identify trends that support training and process improvement.
• Maintain knowledge of audit procedures, configuration standards, mandates, and reference materials to ensure consistent application during audits.
• Participate in calibration discussions and quality reviews to promote consistent audit interpretation and outcomes.
• Support project work and related efforts aligned to team priorities.
• Other duties as assigned.

• High school diploma or GED (Required).
• Two (2) years of work experience in one or more of the following areas: claims, customer service, membership and billing, product configuration, quality, or auditing, including experience using relevant systems and processes (Required).
• One (1) year of auditing experience, such as quality review, configuration audit, operational audit, or comparable experience.
• SQL experience.
• Healthcare experience.
• Experience providing effective, constructive feedback to peers or partners to drive corrections and learning.
• Exposure to health insurance…