Quality Assurance Representative – Medicare

4 days ago

Las Piñas, Philippines Phil-Am Agency Full time

Quality Assurance Representative – Medicare & Health Insurance Get AI-powered advice on this job and more exclusive features. Location: Remote – Philippines Reports To: Quality Assurance Manager / Operations Director (U.S. Based) Company: Phil-Am Insurance LLC Overview Phil-Am Insurance LLC is dedicated to delivering exceptional client experiences with every call. We’re seeking a Quality Assurance Representative based in the Philippines to review, evaluate, and coach our U.S.-based Medicare and Health Insurance teams. This role ensures every client interaction meets our standards of excellence, compliance, and care — while helping our agents continuously improve through thoughtful, constructive feedback. Primary Responsibilities Call Monitoring & Evaluation: Listen to and assess recorded calls from Medicare and ACA (Affordable Care Act) sales and service teams Compliance Oversight: Verify adherence to CMS, HIPAA, and company compliance standards, ensuring proper disclosures, needs analysis, and ethical practices are consistently followed Feedback & Coaching: Provide well-documented, balanced feedback that supports agent growth and reinforces best practices in compliance, communication, and professionalism Quality Reporting: Track performance metrics, identify trends, and elevate recurring issues or training needs to U.S. management Calibration Sessions: Participate in regular QA calibration meetings to maintain scoring accuracy and consistency across the QA team Documentation: Maintain clear, organized QA logs, reports, and audit forms for all evaluated calls Process Improvement: Offer insights to enhance scripts, workflows, and customer experience based on call observations and data patterns Qualifications Minimum 2 years of quality assurance or compliance auditing experience in a call center, preferably in Medicare, health insurance, or telesales Strong understanding of CMS and HIPAA requirements (training provided for Medicare-specific compliance) Excellent written and verbal communication skills in English Analytical mindset with strong attention to detail — accuracy and fairness are key Ability to provide feedback diplomatically, balancing accountability with encouragement Proficient in QA tools and call review platforms (e.g., Five9, Talkdesk, or similar) Comfortable working U.S. business hours (CST/EST) and collaborating with a remote team across time zones Preferred Attributes Prior experience in reviewing Medicare Advantage or ACA calls Background in agent coaching, training, or compliance What We Offer Competitive pay based on experience, with performance-based incentives Work-from-home flexibility with a supportive, people-first culture Opportunity to grow with a U.S.-based agency known for its commitment to quality, ethics, and agent development Training and advancement opportunities in QA leadership, compliance, or operations support #J-18808-Ljbffr

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