ACA Audit & Monitoring Coordinator

Audit & Compliance Monitoring

• Conduct regular audits of agent sales, enrollment.
• Monitor agent adherence to ACA regulations, CMS guidelines, carrier requirements, and internal company policies.
• Review documentation and enrollment records for accuracy, completeness, and compliance.
• Identify compliance violations, trends, and potential areas of risk.
• Maintain audit logs, findings, and corrective action records.

Quality Assurance

• Evaluate agent performance against established quality and compliance standards.
• Prepare quality assurance reports.
• Recommend process improvements to enhance compliance and customer experience.

Reporting & Analysis

• Generate weekly, monthly, and quarterly audit and compliance reports.
• Analyze audit data to identify trends, recurring issues, and training opportunities.
• Present findings and recommendations to management.
• Track corrective actions and follow up to ensure resolution.

Training & Support

• Educate agents on compliance standards, audit findings, and regulatory requirements.
• Partner with Training and Operations teams to develop compliance-related coaching materials.
• Provide guidance regarding ACA regulations, enrollment procedures, and documentation requirements.
• Support the implementation of compliance initiatives and policy updates.