Sr Insurance Operations Quality Assurance Specialist

Responsibilities Conduct daily quality audits for assigned departments Evaluate work for accuracy, completeness, and compliance with company policies and regulatory requirements Perform audits across Claims, Customer Service, New Business, Underwriting, and Policy Services Conduct comprehensive audits of Supplemental Health claims, including complex and high-risk cases Interpret and apply policy provisions, benefit requirements, and limitations Identify processing errors, recurring trends, and root causes for operational improvement Assist with the development and refinement of Quality Audit programs Provide feedback to leadership regarding audit findings and departmental performance Requirements High School Diploma or GED 3+ years of health claims experience Strong understanding of claims processing workflows and Supplemental Health claim administration Ability to interpret policy provisions, benefit requirements, limitations, and exclusions Exceptional attention to detail and strong analytical and critical-thinking skills Ability to evaluate complex information and exercise sound judgment Strong written and verbal communication skills Preferred Qualifications Previous Quality Audit or Quality Assurance experience Experience auditing complex Supplemental Health claims Experience providing technical guidance, training, or calibration support About the Company Horace Mann was founded in 1945 by two Springfield, Illinois, teachers who saw a need for quality, affordable auto insurance for teachers.

We serve more than 4,100 school districts nationwide and help educators protect what they have today and prepare for a successful tomorrow.