Senior Verification Quality Auditor — Remote

Gainwell Technologies LLC; Columbus (OH); A distancia; USD 63.000 - 90.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Generous vacation policy

401(k) employer match

Comprehensive health benefits

Educational assistance

Descripción de la vacante

Gainwell Technologies LLC is seeking a Senior Verification Specialist to independently reassess verification reviews and retest controls across member and provider account access and EFT change requests. You will work with Compliance, Operations, Quality, and Privacy to drive process improvements while maintaining independence from operational decision-making.

Fully remote options are available for most US locations.

Formación

• 5+ years in member services or verification roles.
• Ability to reassess verification reviews and document conclusions.
• Knowledge of authentication, data protection, and escalation processes.
• Strong analytical, organizational, and time-management skills.
• Clear written and verbal communication; report findings to leadership.
• Proficiency with Microsoft Office and SharePoint; use of case-management systems.

Responsabilidades

• Independently reassess completed reviews using an "audit-the-auditor" approach to evaluate completeness, accuracy, consistency, and appropriateness of prior verification reviews, findings, decisions, and escalations.
• Retest verification controls to confirm completed verification activities support identity, representative authority, affiliation, and ownership requirements.
• Assess member and provider interactions related to account access requests and provider EFT changes, ensuring accuracy and compliance.
• Test high-risk request controls by evaluating request completeness, supporting evidence, signatures, and portal activities.
• Report findings and communicate results with clear documentation of scope, methods, risks, and recommendations.
• Escalate critical risks and validate remediation efforts with stakeholders.

Conocimientos

Member verification

Provider verification

Quality reviews

Compliance operations

Risk assessment

Herramientas

SharePoint

Case-management systems

Interaction-recording platforms

Descripción del empleo

Gainwell Technologies LLC is seeking a Senior Verification Specialist to independently reassess verification reviews and retest controls across member and provider account access and EFT change requests. You will work with Compliance, Operations, Quality, and Privacy to drive process improvements while maintaining independence from operational decision-making.

Fully remote options are available for most US locations.