Funding Quality Assurance Auditor

POSITION SUMMARY

The Funding Quality Assurance (QA) Auditor supports the Funding Department by performing detailed audits, ensuring accuracy, and maintaining compliance across all funding related processes. This role is responsible for reviewing daily operational outputs, identifying discrepancies, and helping maintain a high standard of data integrity. As the department’s audit program expands, the QA Specialist will take on additional audit responsibilities, including more complex funding and reimbursement workflows. 

ESSENTIAL FUNCTIONS 

• Audit Daily ACH Files: Review and validate daily ACH files to ensure accuracy, completeness, and alignment with internal and client requirements. 
• Monitor Undelivered Emails: Track undelivered or bounced funding related emails, determine root causes, and ensure proper resolution. 
• Email Assignment and Routing: Review incoming funding inbox emails and accurately assign them to the appropriate Funding Coordinator based on content, client, and workflow type. 
• Stop Loss Reimbursement Audits: Audit stop loss reimbursement applications, ensuring documentation accuracy, correct calculations, and adherence to carrier and internal guidelines. 
• Additional Funding Process Audits: Participate in the development and execution of new audit procedures as the department grows, including but not limited to: 
  • Funding request accuracy 
  • Refund processes 
  • Client specific funding workflows 
  • Compliance driven audit initiatives 
• Process Improvement Support: Identify trends, recurring issues, and opportunities for process improvement. Collaborate with leadership to refine workflows and strengthen internal controls. 
• Other duties as assigned

EDUCATION

• Bachelor's degree or equivalent work experience required. 

EXPERIENCE AND SKILLS

• 3+ years’ experience in health insurance, TPA operations, or a related financial/administrative field required; background in funding, claims, stop loss, or financial auditing strongly preferred
• Familiarity with TPA systems, funding workflows, reimbursement processes, and/or quality assurance practices
• Strong analytical skills with the ability to review data, identify discrepancies, and clearly document findings
• High attention to detail with a quality driven mindset focused on accuracy, compliance, and continuous improvement
• Excellent organizational and time management skills; ability to manage multiple priorities in a fast paced environment and work independently
• Effective written and verbal communication skills, with the ability to collaborate across teams, including Funding Coordinators and leadership
• Adaptable and comfortable with evolving responsibilities and new processes
• Demonstrate professionalism and confidentiality in handling sensitive information
• Proficient in Microsoft Office (Excel, Outlook, Teams) and general data review tools

POSITION COMPETENCIES

• Accountability
• Analytical Thinking
• Collaboration
• Communication
• Customer Focus
• Functional Expertise
• Initiative

PHYSICAL DEMANDS 

• This is a standard desk role requiring extended sitting and computer work. 

 WORK ENVIRONMENT

• Remote 

Here at Allied, we believe that great talent can thrive from anywhere. Our remote friendly culture offers flexibility and the comfort of working from home; while also ensuring you are set up for success. To support a smooth and efficient remote work experience, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload. Reliable internet service is essential for staying connected and productive.

The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

Compensation is not limited to base salary.  Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life and Disability Insurance, Generous Paid Time Off, Tuition Reimbursement, EAP, and a Technology Stipend.

Allied reserves the right to amend, change, alter, and revise, pay ranges and benefits offerings at any time.  All applicants acknowledge that by applying to the position you understand that the specific pay range is contingent upon meeting the qualification and requirements of the role, and for the successful completion of the interview selection and process.  It is at the Company's discretion to determine what pay is provided to a candidate within the range associated with the role.