Quality Assurance Analyst

Raphael & Associates

Quality Assurance Analyst supporting quality assurance and audits at Raphael & Associates, a claims administration firm. Conducting internal audits and enhancing auditing processes with a focus on compliance and client service.

Posted 7/25/2026full-timeRemote • 🇺🇸 United StatesSeniorLeadWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates extensive experience in conducting audits and ensuring compliance with regulatory requirements, while effectively collaborating with cross-functional teams to enhance operational processes and audit workflows.

Highest-signal resume keywords

10+ Years Experience In ClaimsInternal AuditsRegulatory AuditsMicrosoft Office Suite ProficiencyMedicare Compliance

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Audit DocumentationQuality AssuranceRisk IdentificationOperational AnalysisStandardized Procedures Development

Soft Skills

Client LiaisonCommunicationCollaboration

Industry Keywords

Third-Party AdministratorDOI Complaint ResponsesLicensing RequirementsRegulatory Frameworks

About the role

Key responsibilities & impact

Support the ongoing development, maintenance, and enhancement of the organization’s internal auditing platform, including identifying system improvements, testing updates, and optimizing audit workflows.
Conduct comprehensive audits of claim examiners to evaluate adherence to company policies, quality standards, and applicable regulatory requirements, while identifying areas of risk and opportunities for improvement.
Serve as a primary liaison between clients, third-party vendors, and internal stakeholders to coordinate external audit activities, ensuring timely communication and efficient audit execution.
Collect, review, organize, and submit audit-related documentation to support external audits, ensuring accuracy, completeness, and compliance with established requirements.
Collaborate with cross-functional teams to analyze operational processes, identify opportunities for increased efficiency and compliance, and assist in developing and documenting standardized procedures and best practices.
Partner with Training, Legal, and Human Resources departments on special projects, compliance initiatives, policy implementation efforts, and other organizational priorities to support regulatory and business objectives.

Requirements

What you’ll need

10+ years of experience in claims, insurance, quality assurance, and client-facing roles, preferably within a Third-Party Administrator (TPA) environment.
Bachelor’s degree preferred; equivalent professional experience will be considered.
Advanced proficiency in Microsoft Office Suite (Excel, Word, Outlook, PowerPoint).
Demonstrated experience with internal, client, and regulatory audits, including DOI complaint responses.
Working knowledge of licensing requirements, Medicare compliance, and other regulatory frameworks.

Benefits

Comp & perks

Excellent Salary
Multiple Bonus Opportunities
Medical Benefits including Dental, Vision and Life
Paid Holidays/Vacation
401(k) Plan
Flex-Time
Educational Assistance Program