Global Quality Assurance Specialist

IMG is a global International Medical Insurance company serving individuals and organizations of all sizes. Our products help travelers and expatriates maintain global peace of mind®. We are growing our teams with people who share energy and enthusiasm for creating the best experience for travelers.

JOB DETAILS

• Location:
  
  Flexible work options — Located in Indianapolis, IN;
  Remote, Hybrid and In-Office schedules available
• Schedule:
  
  7.5 hours per day, Mon-Fri, between 08:00–20:00 (EST or GMT)
• Relocation Expenses Reimbursed:
  No
• Qualified candidates must be legally authorized to be employed in the United States. IMG will not be providing sponsorship for employment visa status (e.g., H-1B or TN) for this position.

JOB SUMMARY

The Global Quality Assurance Specialist will be a key member of the Global Quality & Process Improvement Team and will work closely with Global Quality leadership to ensure the highest level of complaint, escalation and appeal handling and quality assurance in line with client or regulatory requirements. The role includes ensuring customer complaints, appeals or escalations are handled promptly, accurately and efficiently, supporting quality & process improvement initiatives, and managing complex, escalated and regulated complaints with appropriate escalation to Global Quality Leadership as required.

The Specialist will interact with insured members, medical providers, underwriters, brokers/producers, regulators and other third parties by phone and email while ensuring outcomes are compliant with policy terms and regulatory requirements.

DUTIES AND RESPONSIBILITIES

• Effectively and accurately manage complaints across all areas of the business, including those regulated by FCA/ICB/DOI.
• Review all complaints in line with FCA/ICB/DOI regulations to establish the cause, ensuring all are acknowledged, logged, and managed through to resolution.
• Complete and register all Financial Ombudsman Service (or other regulatory body) file requests.
• Communicate with underwriters, customers, regulatory bodies and internal teams regarding ongoing complaints and keep all relevant parties updated.
• Review appeals and manage to resolution.
• Leverage technology and customer feedback to improve the customer journey.
• Complete quality checks and audits, and report results to department management where required.
• Communicate any service delivery issues, training needs, or complaints (actual or likely) to the Global Quality Team Leader.
• Collaborate with Operations and claims management to improve quality and performance through case reviews.
• Assist the Global Quality Leadership team to identify and evaluate business processes and customer journeys, helping to develop and implement quality and compliance metrics and identifying opportunities to improve service quality.
• Carry out any other tasks with adequate training, at short notice, as agreed with the line manager or management team.
• Share feedback and recommendations with relevant managers on process and training.

QUALIFICATIONS

• Minimum 3 years of experience in a regulated insurance environment, preferably in a claims handling, complaints handling and/or customer service role.
• Excellent communication skills with the ability to interact effectively with customers, team members, and senior management.
• Analytical mindset with the ability to interpret data, identify trends, and make data-driven decisions.
• Attention to detail and good listening skills; ability to follow complex instructions.
• Good interpersonal and customer service skills (both written and spoken).
• Enthusiastic, self-motivated with a ‘can do’ attitude.
• Solid working knowledge of Microsoft Word, Outlook and Excel.
• Ability to work under pressure as part of a close-knit team.
• Excellent organizational skills, including the ability to prioritize workload and use own initiative.

PREFERRED SKILLS

• Minimum 1 year experience in a complaints handling role in a regulated environment.
• Previous experience with handling appeals, complex case or claim reviews and/or quality auditing (training can be provided).
• Previous experience and/or proven working knowledge of performing claims adjustments.
• Command of medical coding such as ICD-10 and…