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Quality Assurance Analyst (Insurance Exp Required)- Work from Home / Dayshift image - Rise Careers
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Quality Assurance Analyst (Insurance Exp Required)- Work from Home / Dayshift

  • Claims Quality Assurance & Analysis · Conduct Open File Reviews (OFR) weekly to assess pending claims and detect potential leakages before finalisation
  • Assess 15 pending claims per week for both Australia and New Zealand.
  • Assess 5 declined claims per week (prior to decline letter being sent) for both Australia and New Zealand.
  • Provide feedback to agents or assessors for necessary remediation and corrective actions.
  • Conduct Closed File Reviews (CFR) monthly to evaluate settled and authorised claims per assessor. o Assess 10 claims per assessor monthly (5 by CFR Analyst & 5 by QA Analyst) for Australia and New Zealand.
  • Ensure CFR samples cover all policy types including Superior Range, Mid-Range, Safety Net, Introductory Covers, Equine, and Exotics. o Identify errors, compliance gaps, and opportunities for training and report to the Claims Manager. Call Quality Assurance & Customer Service Review.
  • Review inbound and outbound calls to evaluate the quality of customer interactions and adherence to service standards.
  • Provide monthly Call QA reports across Australia and New Zealand.
  • Identify service gaps, areas of improvement, and provide constructive feedback to teams.
  • Reporting and continuous Improvement.
  • Prepare monthly reports summarising findings from OFR, CFR, and Call QA.
  • Identify and escalate recurring issues to relevant teams for training and process enhancement.
  • Collaborate with the Claims Manager and 2IC to support training and coaching initiatives based on QA findings.
  • Ensure compliance with internal claims policies and industry regulations.
  • Other role specific duties as they arise.
  • Bachelor's degree in a relevant field such as Business, Insurance, Finance, or a related discipline.
  • Strong attention to detail and ability to identify potential errors and process inefficiencies.
  • Analytical mindset with problem-solving skills to detect and address potential claim leakages.
  • Strong understanding of insurance products and services, particularly within Australia and New Zealand.
  • Experience in quality assurance, claims assessment, or compliance roles (preferably in insurance or financial services).
  • Strong written and verbal communication skills to provide clear, actionable feedback.
  • Ability to work independently and manage multiple review processes simultaneously.
  • Proficiency in data analysis and reporting tools.
  • Strong knowledge of claims processes, policy types, and regulatory compliance.
  • Previous experience in pet insurance or general insurance is highly desirable.

As a Twoconnect employee, you get to enjoy the following:

  • Work from home
  • Shift: Monday to Friday: 9:00 am to 6:00 pm AEST / AEDT
  • Work-life balance
  • Training and Development programmes
  • Employee Engagement Events (company outings, fun activities, quarterly wellness and self-care sessions)
  • Experience working with leading organisations
  • Fun, supportive, and inclusive culture
  • Dedicated Team Managers that look after your development 
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Full-time, remote
DATE POSTED
April 8, 2025

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