Operations & Compliance Auditor

About the 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.

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
  • 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

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

What we offer

• 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
• A great culture where you work with the founders and key stakeholders in a relaxed, but innovative atmosphere
• UHSM is an Equal Opportunity Employer