Quality Auditor | Health Insurance

AppleOne Employment Services; San Juan (PR); On-site; USD 29,000 - 35,000; Full time

Job summary

AppleOne is seeking a detail-oriented QA professional to support product development and regulatory document validation in a fast-paced insurance environment.

You will review high-volume health insurance materials, ensure accuracy, and help deliver compliant benefits content such as Summary of Benefits and EOC documents.

Qualifications

• High School Diploma or Technical Commercial Course required.
• Six months to one year of related experience required.
• Intermediate computer skills required.
• Intermediate English skills required.
• Strong attention to detail and ability to review high-volume documents with accuracy.
• Ability to identify inconsistencies, data gaps, and documentation errors.
• Strong organization, time management, and follow-through skills.
• Ability to work in a deadline-driven environment with multiple internal stakeholders.

Responsibilities

• Validate, maintain, and review product-related materials for accuracy and completeness.
• Perform detailed quality reviews of product policies, benefit configurations, supporting documentation, and regulatory materials.
• Reproduce, update, review, and validate mandated documents such as Summary of Benefits, Annual Notice of Change, Evidence of Coverage, and related CMS-required materials.
• Conduct spot checks, peer reviews, data validation, and discrepancy tracking to identify gaps, inconsistencies, and required corrections.
• Collaborate with Compliance, Marketing, Operations, and internal teams to resolve feedback and support timely delivery of required materials.
• Manage assigned deliverables and timelines to help the team meet operational targets and production deadlines.

Skills

Attention to detail

Discrepancy detection

Time management

English communication

Education

High School Diploma or Technical Commercial Course

Tools

Microsoft Office

Job description

This role supports product development, regulatory document validation, data quality, and mandated health insurance materials for a fast-paced insurance environment.

This is an excellent opportunity for quality-focused professional who enjoys reviewing detailed information, identifying discrepancies, and supporting compliance-driven deliverables. The position offers exposure to health insurance product operations, regulatory materials, cross-functional collaboration, and high-volume document production. Candidates who are organized, accurate, and comfortable working with deadlines will be well positioned for success.

Key Responsibilities

• Support Product Development initiatives by validating, maintaining, and reviewing product-related materials for accuracy and completeness.
• Perform detailed quality reviews of product policies, benefit configurations, supporting documentation, and regulatory materials.
• Reproduce, update, review, and validate mandated documents such as Summary of Benefits, Annual Notice of Change, Evidence of Coverage, and related CMS-required materials.
• Conduct spot checks, peer reviews, data validation, and discrepancy tracking to identify gaps, inconsistencies, and required corrections.
• Collaborate with Compliance, Marketing, Operations, and internal teams to resolve feedback and support timely delivery of required materials.
• Manage assigned deliverables and timelines to help the team meet operational targets and production deadlines.

Compensation and Benefits

• Pay: $32,000 per year.
• Job Type: Contract/Temporary.
• Location: San Juan, PR.

Required Qualifications and Skills

• High School Diploma or Technical Commercial Course required.
• Six months to one year of related experience required.
• Intermediate computer skills required.
• Intermediate English skills required.
• Strong attention to detail and ability to review high-volume documents with accuracy.
• Ability to identify inconsistencies, data gaps, and documentation errors.
• Strong organization, time management, and follow-through skills.
• Ability to work in a deadline-driven environment with multiple internal stakeholders.

Preferred Qualifications

• Experience in health insurance, managed care, compliance, quality review, product documentation, or administrative support.
• Familiarity with regulatory materials such as Summary of Benefits, Evidence of Coverage, Annual Notice of Change, or related plan documents.
• Experience supporting cross-functional teams in Compliance, Operations, Marketing, or Product Development.

Equal Opportunity Employer / Disabled / Protected Veterans

The Know Your Rights poster is available here: https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12.pdf

The pay transparency policy is available here: https://www.dol.gov/sites/dolgov/files/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdf

For temporary assignments lasting 13 weeks or longer, AppleOne is pleased to offer major medical, dental, vision, 401k and any statutory sick pay where required.

We are committed to working with and providing reasonable accommodations to individuals with disabilities. If you need a reasonable accommodation for any part of the employment process, please contact your staffing representative who will reach out to our HR team.

AppleOne participates in the E-Verify program in certain locations as required by law. Learn more about the E-Verify program. https://e-verify.uscis.gov/web/media/resourcesContents/E-Verify_Participation_Poster_ES.pdf

We also consider for employment qualified applicants regardless of criminal histories, consistent with legal requirements, including, if applicable, the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance. Pursuant to applicable state and municipal Fair Chance Laws and Ordinances, we will consider for employment-qualified applicants with arrest and conviction records, including, if applicable, the San Francisco Fair Chance Ordinance. For Los Angeles, CA applicants: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.