Remote Senior Quality Verification Specialist

Gainwell Technologies; Texas; Remote; USD 63,000 - 90,000; Full time

Job summary

Gainwell Technologies is seeking a Senior Quality Verification Specialist to perform independent quality and compliance reviews of member and provider interactions involving account access requests and provider EFT changes. This role ensures requests are handled securely and according to procedures.

You will reassess completed reviews, retest controls, and report findings, partnering with Compliance, Operations, Quality, Privacy, Security to drive improvements while maintaining independence from

Qualifications

• Five or more years of experience in member services, member or provider verification, or related fields.
• Ability to independently reassess verification reviews and retest controls.
• Knowledge of authentication, information protection, and escalation workflows.
• Strong analytical, organizational, and written/verbal communication skills.
• Experience with CXone or similar interaction-review platforms.

Responsibilities

• Reassess completed verification reviews using an audit-the-auditor approach.
• Retest verification controls to validate evidence and handoffs.
• Assess member/provider interactions related to account access requests and EFT changes.
• Test high-risk request controls and verify documentation standards.
• Report findings with risk-based recommendations to leadership and process owners.
• Escalate critical risks and validate remediation actions.

Skills

Independent reassessment

Audit-the-auditor approach

Retest controls

Communication of findings

Legal and regulatory compliance

Tools

Microsoft Office

SharePoint

Case-management systems

Job description

Gainwell Technologies is seeking a Senior Quality Verification Specialist to perform independent quality and compliance reviews of member and provider interactions involving account access requests and provider EFT changes. This role ensures requests are handled securely and according to procedures.

You will reassess completed reviews, retest controls, and report findings, partnering with Compliance, Operations, Quality, Privacy, Security to drive improvements while maintaining independence from