Complaint Resolution Analyst

Complaint Resolution Analyst

Supports the Company’s agent monitoring, anti-fraud, and consumer complaint programs.

Responsibilities

• Communication & program support: Provide agents, internal teams, and third-party administrators with support and education on compliance programs.
• Consumer complaint handling:
  • Investigate and review consumer, agent, and Department of Insurance complaints.
  • Collect and analyze documentation, transactions, and correspondence.
  • Draft accurate, timely, and regulation-compliant responses.
  • Maintain the complaint database, track outcomes, and archive relevant documents.
  • Produce management reporting on complaint trends and report recurring issues.
• Agent monitoring:
  • Perform monitoring under the Red Flag system related to complaints.
  • Support screening of producers seeking appointment.
  • Respond to state regulator inquiries regarding agents or fraud investigations.
  • Assist in continuously improving the Agent Monitoring Program.
• Anti-fraud investigation:
  • Review documents and files, develop investigative plans, and report findings to management.
  • Recommend and/or perform actions to mitigate risk (e.g., terminations, dismissals, probationary actions).
  • Support ad-hoc investigative requests.
• Collaboration & escalation: Engage compliance management and corporate counsel for unusual cases, sales practice issues, fraud concerns, or complaint matters.

Supervisory scope

• No formal people-management responsibilities; may provide guidance/mentorship or subject-matter expertise.

Requirements

• Strong written and verbal communication
• Strong organization and attention to detail
• Analytical skills with ability to work with detailed information
• Ability to manage multiple priorities in a fast-paced environment
• Working knowledge of insurance rules and regulations

Qualifications

• Bachelor’s degree
• 2+ years of relevant experience in insurance compliance, investigative, or operational roles

Nice to have

• Insurance/financial designations or coursework related to compliance/ethics/anti-fraud (e.g., LOMA FLMI, AIRC, CFE)
• Paralegal certificate or legal support background