Perform monthly reconciliation of member databases between partner carriers and the administrator's database;
Analyze, validate, and organize data, operational indicators, and operational results;
Investigate and resolve discrepancies in registrations and in movements of member additions, removals, and changes, working with internal teams and carriers as needed;
Support the prevention of financial losses and negative impacts on member service;
Prepare management and operational reports;
Maintain controls, spreadsheets, and databases in an organized manner, ensuring traceability, reliability, and information governance;
Support continuous improvement of reconciliation and data control processes, proposing standardizations, automations, and efficiency gains;
Collaborate with departments such as Customer Service, Finance, Legal, Enrollment, IT, and Carriers;
Ensure compliance with internal policies, quality standards, and applicable regulatory requirements.

Bachelor's degree completed or in progress;
Previous experience in operations, reconciliations, data analysis, or management of member databases, preferably in the health, benefits, or insurance sectors;
Intermediate to advanced Excel skills;
Experience analyzing large volumes of data and handling sensitive information;
Knowledge of operational indicators (KPIs) and BI tools is desirable;
Experience with benefits administrators, health insurers, or insurance companies;
Knowledge of billing processes and membership movements (enrollments, terminations, and changes);
Experience in process improvement projects or automation of operational controls.

Operations Quality Analyst

Key skills