Customer Service Specialist
Designation: Customer Service Specialist
Qualifications:Any Graduation
Years of Experience:8-12 years
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What would you do? The Quality Assurance Manager for an insurance account is responsible for overseeing the end to end quality governance framework across policy administration, claims processing, underwriting support, and customer service for group retirement operations. The role provides strategic direction, ensures compliance with regulatory and client standards, drives process excellence, and leads initiatives to improve accuracy, reduce defects, and strengthen risk controls.Covers the full range of services needed throughout a plans life, including plan development & enhancement, sales & marketing, plan sponsor/institutional client onboarding/management, participant enrollment/management, sponsor and member servicing & reporting. Their products consist of individual retirement accounts (Roth IRA), college savings accounts, guaranteed investment contracts, fixed & variable deferred annuities (qualified & non qualified), as well as corporate retirement funds.
What are we looking for? The Quality Assurance Manager for an insurance account is responsible for overseeing the end to end quality governance framework across policy administration, claims processing, underwriting support, and customer service for group retirement operations. The role provides strategic direction, ensures compliance with regulatory and client standards, drives process excellence, and leads initiatives to improve accuracy, reduce defects, and strengthen risk controls.This leader will manage Quality Analysts, lead cross functional alignment, and partner with Operations, Training, Compliance, and Client stakeholders to deliver a highly reliable and compliant insurance service environment.Quality Governance & Operational OversightReporting, Insights & CommunicationRoot Cause Analysis & Continuous ImprovementCompliance, Risk Management & Audit ReadinessTeam Leadership & Capability Development
Roles and Responsibilities: Key Responsibilities1. Quality Governance & Operational OversightLead the quality monitoring program across calls, emails, and back office insurance transactions.Ensure accuracy and compliance in policy issuance, endorsements, cancellations, billing, and claims-related processing.Oversee adherence to insurance regulations, client SLAs, and data privacy requirements.Identify systemic issues, risk exposures, and process gaps impacting customer experience or compliance.2. Reporting, Insights & CommunicationReview and approve QA reports, dashboards, scorecards, and quality trend analyses prepared by the team.Provide actionable insights to leadership based on error patterns, compliance gaps, and transaction risk.Present monthly and quarterly quality performance updates to internal and client stakeholders.Maintain governance documentation, audit logs, and calibration records.3. Root Cause Analysis & Continuous ImprovementLead and guide Root Cause Analysis (RCA) efforts for recurring errors and compliance deviations.Develop and track corrective/preventive action plans to reduce defects and improve service delivery.Partner closely with Trainers, SMEs, and Process Leaders to strengthen SOPs and enhance team capability.Ensure scoring consistency across teams through structured calibration sessions.4. Compliance, Risk Management & Audit ReadinessOversee quality compliance checks related to insurance processes, including data entry accuracy, documentation completeness, requirements management, and policy issuance.Identify potential compliance risks such as misquoting, incomplete documentation, and incorrect policy setup.Support internal and external audits by providing required evidence, documentation, and quality insights.Ensure the QA team aligns with regulatory expectations and client mandated guidelines.5. Team Leadership & Capability DevelopmentManage and mentor Quality Analysts to enhance domain knowledge, analytical capability, and quality evaluation skills.Establish team goals, performance metrics, and development plans.Foster a culture of continuous learning, process discipline, and quality ownership across operations.
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