Operations & Compliance Auditor

About This Role

The Operations & Compliance Auditor ensures accuracy, compliance, and efficiency across call-center and operational workflows. This role conducts advanced, risk-based audits across multiple communications channels, identifies systemic gaps, and provides strategic insights that protect revenue, data integrity, and member experience. Operating with minimal supervision, the auditor serves as a subject matter expert, escalation resource, and partner to leadership on quality, compliance, and process improvement initiatives.

Key Responsibilities

• Quality Oversight & Multi-Channel Auditing
  • Conduct risk-based audits across calls, case documentation, emails, texts, escalations, exceptions, and retention/saves
  • Perform high-risk and escalated audits requiring independent judgment and regulatory awareness
  • Identify systemic process gaps, compliance deviations, terminology inconsistencies, operational risks, and provide actionable recommendations
  • Perform peer-to-peer audits and audit the auditors
• Operational Expertise & Escalation Support
  • Serve as a subject matter expert for eligibility, application outcomes, cancellations, reinstatements, saves, and compliance workflows
  • Act as an escalation resource for complex or high-risk cases
  • Ensure adherence to internal protocols, documentation standards, and compliance requirements
  • Proactively identify and resolve operational or compliance issues with a solutions-oriented approach
• Trend Analysis & Strategic Insight
  • Analyze audit trends and performance metrics to support leadership decision-making
  • Identify recurring errors, blind spots, and systemic issues and contribute to process improvement planning
  • Provide complete, accurate reporting with clear recommendations
  • Participate in calibration sessions to ensure consistent scoring
  • Detect errors impacting revenue, billing accuracy, eligibility, or member records
  • Support special projects and implementation of safeguards that protect revenue and reputation
• Reporting, Documentation, & System Optimization
  • Maintain accurate audit logs and documentation
  • Support development of audit scorecards, QA workflows, and reporting frameworks
  • Participate in system optimization initiatives to improve operational efficiency
• Reliability & Performance
  • Consistently meet or exceed KPIs with minimal supervision
  • Demonstrate strong follow-through, confidentiality, and discretion with sensitive data
  • Maintain a solutions-oriented mindset in resolving operational challenges

Required Qualifications

• HS Diploma/GED or higher
• 1+ year in QA, auditing, compliance review, call-center QA, or customer service
• Experience auditing calls, written correspondence, and case documentation
• Strong analytical skills with trend and root-cause identification
• High attention to detail, risk assessment ability, and independent judgment
• Strong written and verbal communication skills
• Proven reliability, confidentiality, and ability to provide objective feedback
• Excel proficiency and experience creating structured reports
• Demonstrated process-improvement and system-optimization experience
• Strong organizational skills and ability to work with minimal supervision

Preferred Qualifications

• Experience in healthcare, health-sharing, insurance, or non-profit environments
• Familiarity with compliance frameworks and HIPAA
• Bilingual (Spanish/English) and tech-savvy

Benefits

• Competitive hourly and benefits package, including health, life dental, and vision insurance, 403(b) with company match, and time off
• The chance to make a meaningful impact in the lives of individuals and families seeking affordable, faith-based healthcare solutions
• Great culture where you work with the founders and key stakeholders in a relaxed, but innovative atmosphere