Full-Time Quality Review Auditor

We’ve Got You Under Our Wing

We are the duck. We develop and empower our people, cultivate relationships, give back to our community, and celebrate every success along the way. We do it all…The Aflac Way.

Aflac, a Fortune 500 company, is an industry leader in voluntary insurance products that pay cash directly to policyholders and one of America's best-known brands.

What does it take to be successful in this role?

• Attention to detail and a strong grasp of clinical and/or vocational, ADA decision frameworks.
• Clear and professional written communication skills for feedback documentation.
• Comfortable working with audit tools, tracking outcomes and utilizing tech platforms.
• Strong organizational and time management skills with the ability to manage multiple audits and deadlines.
• Ability to work independently while adhering to standardized audit procedures.

Education & Experience Required

• Bachelor's Degree Nursing, Business, Healthcare or related filed
• 3 or more years of experience performing assessment/reviews in a related field.
• Active clinical license RN, or professional vocational certification (role specific, clinical or VRC).
• Active clinical license e.g., LCSW, LMHC, LPC, or equivalent clinical license.
• Or an equivalent combination of education and experience

Principal Duties & Responsibilities

• Perform internal audits of reviews and/or deliverables to evaluate adherence to criteria, internal policies, and documentation standards.
• Review documentation for completeness, clarity, and alignment with established protocols and approved guidelines.
• Use standardized audit tools and scorecards to ensure consistent assessment of reviewer performance.
• Document audit findings and provide targeted, constructive feedback to reviewers.
• Collaborate with leadership to track audit outcomes and identify recurring issues or trends in reviewer performance.
• Participate in calibration sessions and inter-rater reliability checks to ensure audit consistency.
• Support training and coaching efforts by flagging opportunities for additional education or process improvement.
• Assist in maintaining audit documentation and records in accordance with organizational policies.
• Escalate high-risk findings or patterns of concern to leadership for further action.
• Contribute to continuous improvement of audit tools, scorecards, and internal guidelines by providing field-based insight.
• Participate in teams based internal QA meetings, audit calibration discussions, and feedback delivery sessions.
• Maintain confidentiality and compliance with HIPAA and other applicable regulations when handling employee/claims data.
• Stays informed regarding industry trends and best practices in product and service delivery.
• Leads and participates in QA initiatives to enhance outcomes, customer satisfaction, and operational efficiencies.
• Performs other duties as assigned.

What is the last date for applying to the job?

Which countries are accepted for this remote job?