Agent Oversight Analyst

Tranzact•Raleigh, NC

About The Position

The Agent Oversight Analyst supports the analytical work behind the department's investigation lifecycle — reviewing and prioritizing complaints, tracking cases against service-level expectations, and turning case data into the trends and metrics leadership uses to drive accountability. The ideal candidate thinks in terms of risk, patterns, and root causes, not just checklists.

Requirements

  • High school diploma or equivalent
  • 1+ year in compliance, QA, operations, insurance, healthcare, or related field
  • Demonstrated ability to analyze data, identify trends, and use sound judgment
  • Strong Excel/Microsoft Office skills
  • Ability to learn new systems quickly
  • Strong written/verbal communication
  • Able to work independently with confidential information

Nice To Haves

  • Medicare, healthcare, or insurance compliance experience
  • Experience with Jira, QuickBase, Smartsheet, or similar systems
  • Associate's/Bachelor's degree or relevant certification

Responsibilities

  • Review, evaluate, and log incoming complaints and allegations from carriers, CMS/CTM channels, internal referrals, and sales leadership; classify by type, carrier, and priority.
  • Identify duplicate or related cases and escalate high-risk matters to the Manager, Carrier Compliance and Oversight.
  • Analyze caseload and case mix to support assignment decisions; monitor case aging and service-level adherence, flagging at-risk cases and root causes to management.
  • Build and analyze reports on complaint volume, trends, case aging, and outcomes to surface issues requiring leadership attention or corrective action.
  • Maintain dashboards and tracking tools; prepare materials for leadership and carrier discussions.
  • Serve as point of contact for carriers, sales leadership, and investigators on case status and documentation.
  • Monitor outstanding CAP and agent-response requirements, flagging non-response patterns and escalating unresolved items.
  • Gather and organize investigation documentation (lead data, audit findings, enrollment records, call recordings); identify information gaps.
  • Support special projects and process improvements, including automation opportunities.
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