Quality Assurance Specialist
The Quality Assurance Specialist (QA) responsibilities would include defining and documenting business requirements, assisting with special projects, engaging subject matter experts across the operation to facilitate reviews, develop strategies and track results to create and measure operational efficiencies for Claims.
The Claims Quality Assurance Analysts will have superior technical expertise and support each claims segment by reviewing claim files, providing reports of findings, ensuring adherence with compliance, and working to improve overall file quality.
- Serve as subject matter expert for claims, including data analytics, claim trending, identifying training needs, and developing action plans to add
- Design and implementation consistent quality assurance process across the claim’s
- Have advance knowledge of Xactimate, Estimatics, Xactanalysis and data reports, and being able to take the information from reports and under the data provided to identify and verify
- Strong understanding of Claims Strategy and Handling and
- Assist with the execution of claims strategy for designated line of business,
- Collaborate with claims management, legal, and other claims product teams to develop strategies and business plans to improve efficiency and
- Claim targets: Assisting with driving the achievement of department and company results and contribute to annual target setting for
- Responsible for providing Director of QA with regular updates regarding Quality Assurance metrics and trends,
- Ensure claim handling in accordance with State, corporate and local claims handling
- Support Claims Leadership Team through regular reporting of quality assurance results and
- Undertake audits of internal adjusters and external service providers as
- Coordinate resources to respond to internal and external auditor
- Respond to regulatory data reporting requests as
- Gather data from across the business to develop, plan, facilitate, and present conclusions and work closely with training partners to develop targeted training
- Ensure that proposed solutions are focused on improving efficiency and effectiveness of the business process for the claims department and are consistent across all lines when
- Participate in the development and planning of strategies, including planning, huddles, process improvement manuals, analysis if data and implementation of process,
- Work with process team to ensure their designs and implementations meet the business
- Assist in the development of document configuration requirements/solutions including step-by-step procedural guides; overview material; field specific definitions; explanation of reporting functions; training materials; tracking of system modifications,
- Language Skills: Must possess the ability to read and comprehend detailed instructions, correspondence, and memos as well as write simple Must also be able to effectively present information in one-on-one and small group situations to claim representative, management, and other employees of the organization.
- Mathematical Skills: Must be proficient with the following: addition, subtraction, multiplication, and division in all units of measure, using whole numbers, common fractions, and
- Reasoning Ability: Must be able to apply common sense understanding to carry out instructions furnished in written, oral, or diagram Must also be able to deal with problems involving several concrete variables in standardized situations.
- Computer Skills: Must be proficient with programs such as Word, Excel, Outlook, Adobe and other programs used by the company such as Guidewire, Legacy, Xactimate and
- Comfortable working independently with a high degree of proficiency and self-motivation.
SUPERVISORY RESPONSIBILITIESThis job has no supervisory responsibilities.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Strong organizational and task management skills. Strong relationship management and proven experience delivering high level if internal and external customer service. Computer proficiency with strong skills in Microsoft Office applications. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
EDUCATION AND/OR EXPERIENCE
- College degree and/or equivalent insurance Excellent oral and written communication skills
- Excellent organizational skills, ability to multi-task and set priorities,
- Ability to solve complex problems analytically and work independently,
- Ability to do research and work with subject matter experts,
- Expert knowledge of the insurance industry, preferably homeowner’s insurance with a strong understanding of claims, understanding of litigation process, appraisal and AOB handling, Xactimate, Estamatics, and Data,
- Strong knowledge of state compliance requirements and homeowner insurance policy
- Experience with the Guidewire suite of products is preferred,
- Experience with anti-fraud efforts as it relates to homeowner’s insurance,
- Proficient in MS Office
CERTIFICATES, LICENSES, REGISTRATIONS
Preferred but not required: 620 or 520 license, six sigma, training certifications, claims designations, Xactimate certifications.
Must possess the ability to read and comprehend detailed instructions, correspondence, and memos as well as write simple correspondence. Must also be able to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.
Must be proficient with the following: addition, subtraction, multiplication, and division in all units of measure, using whole numbers, common fractions, and decimals.
Must be able to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Must also be able to deal with problems involving several concrete variables in standardized situations.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel; and talk or hear. The employee frequently is required to reach with hands and arms. The employee is occasionally required to stand and walk. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus.
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.
NOTE: This is not necessarily an exhaustive list of responsibilities, skills, duties, requirements, efforts or working conditions associated with the job. While this list is intended to be an accurate reflection of the current job, Frontline Insurance reserves the right to revise the functions and duties of the job or to require that additional or different tasks be performed when circumstances change.
We are a Drug Free Workplace and EOE.