Quality Assurance, Risk Control & Special Investigations Analyst

The Quality Assurance, Risk Control & Special Investigations Analyst is responsible for driving process improvement and mitigating risk. Three key functions include: auditing call and service interactions, conducting pre-referral fraud investigations while providing supporting documentation regarding alleged fraud inquiries, and monitoring internal controls. The analyst will conduct quality audits of inbound and outbound call center interactions, review completed service and administrative forms, and deliver feedback to call center agents. They will also analyze cases flagged for potential fraudulent activity, collect documentation, and prepare well-documented case files for referral to the insurance carrier’s Special Investigations Unit (SIU).