Operations & Compliance Auditor

Operations & Compliance Auditor

Healthcare is increasingly unaffordable for many Americans. Most people believe they have two choices: increasingly expensive, restrictive employer insurance, or an ACA plan that keeps getting pricier. Many don't know there's a third, smarter option.

WeShare Health is that option. 

WeShare Health’s mission is to make healthcare simpler, more affordable, and more human. We're a nonprofit, faith-inspired healthcare sharing organization where members contribute monthly to share one another's eligible medical expenses. We're proudly not insurance, and that's the point. 

Members access a national network of 1 million physicians at 30 to 60 percent less than comparable traditional insurance. Since 2018, WeShare Health has served more than 100,000 members and shared more than $50 million in medical expenses. Our purpose is clear: people before profit.

WeShare Health is led by senior executives with deep experience across for-profit and nonprofit enterprises. We’re rated 4.6 out of 5 on Google Reviews, rated 4.7 on Trustpilot by members and certified as a Great Place To Work® by our employees. If you have a bias for action, enjoy challenges, and want to challenge the status quo to make an impact in a massive industry, WeShare Health might be the place for you!

About this role

The Operations & Compliance Auditor ensures accuracy, compliance, and efficiency across call-center and operational workflows. This role conducts advanced, risk-based audits across multiple communications channels, identifies systemic gaps, and provides strategic insights that protect revenue, data integrity, and member experience.

Operating with minimal supervision, the auditor serves as a subject matter expert, escalation resource, and partner to leadership on quality, compliance, and process improvement initiatives. 

Key Responsibilities

Quality Oversight & Multi-Channel Auditing

• Conduct risk-based audits across calls, case documentation, emails, texts, escalations, exceptions, and retention/saves
• Perform high-risk and escalated audits requiring independent judgment and regulatory awareness 
• Identify systemic process gaps, compliance deviations, terminology inconsistencies, operational risks, and provide actionable recommendations
• Perform peer-to-peer audits and audit the auditors 

Operational Expertise & Escalation Support

• Serve as a subject matter expert for eligibility, application outcomes, cancellations, reinstatements, saves, and compliance workflows 
• Act as an escalation resource for complex or high-risk cases
• Ensure adherence to internal protocols, documentation standards, and compliance requirements
• Proactively identify and resolve operational or compliance issues with a solutions-oriented approach

Trend Analysis & Strategic Insight

• Analyze audit trends and performance metrics to support leadership decision-making
• Identify recurring errors, blind spots, and systemic issues and contribute to process improvement planning 
• Provide complete, accurate reporting with clear recommendations 
• Participate in calibration sessions to ensure consistent scoring
• Detect errors impacting revenue, billing accuracy, eligibility, or member records
• Support special projects and implementation of safeguards that protect revenue and reputation 

Reporting, Documentation, & System Optimization 

• Maintain accurate audit logs and documentation 
• Support development of audit scorecards, QA workflows, and reporting frameworks
• Participate in system optimization initiatives to improve operational efficiency

Reliability & Performance

• Consistently meet or exceed KPIs with minimal supervision
• Demonstrate strong follow-through, confidentiality, and discretion with sensitive data
• Maintain a solutions-oriented mindset in resolving operational challenges

Required Qualifications

• HS Diploma/GED or higher 
• 1+ year in QA, auditing, compliance review, call-center QA, or customer service 
• Experience auditing calls, written correspondence, and case documentation 
• Strong analytical skills with trend and root-cause identification 
• High attention to detail, risk assessment ability, and independent judgment
• Strong written and verbal communication skills
• Proven reliability, confidentiality, and ability to provide objective feedback
• Excel proficiency and experience creating structured reports
• Demonstrated process-improvement and system-optimization experience 
• Strong organizational skills and ability to work with minimal supervision

Preferred Qualifications

• Experience in healthcare, health-sharing, insurance, or non-profit environments 
• Familiarity with compliance frameworks and HIPAA
• Bilingual (Spanish/English) and tech-savvy 

What we offer

• Competitive hourly and benefits package, including health, life dental, and vision insurance, 403(b) with company match, and time off
• The chance to make a meaningful impact in the lives of individuals and families seeking affordable, faith-based healthcare solutions
• Great culture where you work with the founders and key stakeholders in a relaxed, but innovative atmosphere