Casualty Claims Quality Assurance Consultant

EMC Insurance Companies

3d•$85,799 - $130,394•Remote

About The Position

At EMC, we’re all about working together to make an impact. As part of our team, you’ll have the opportunity to grow, contribute, and gain experience that matters. We strive to be caring leaders, close partners, and responsive experts—always supporting each other to do our best work. Join us, and let’s improve lives together. This position is eligible to work from home anywhere in the US. In this role, you’ll play a key part in strengthening the quality and consistency of casualty claims handling across the organization. You’ll partner closely with Casualty, Complex, and Specialty teams to review claim files, evaluate performance against best practices and KPIs, and identify opportunities to improve outcomes. Through targeted audits and broader claims reviews, you’ll uncover trends, provide actionable insights, and help drive accountability and continuous improvement. You’ll also collaborate with leadership to shape audit standards, support training efforts, and implement process enhancements that elevate claims handling quality. Your work will directly impact how claims are managed by ensuring consistency, reducing risk, and improving overall results for both the business and its customers.

Requirements

Bachelor’s degree, preferably in insurance, finance, accounting, business administration or related field or equivalent relevant experience
Eight years of commercial lines casualty claim handling experience, including experience with litigated claims or related experience
Excellent understanding of the casualty claims function
Strong understanding of casualty claims handling procedures, principles, standards and best practices
Strong knowledge of medical and legal terminology and legal aspects of court procedures affecting legal liability
Ability to audit claim files for consistency
Strong ability to gather facts, analyze alternatives and recommend solutions
Excellent organizational and analytical skills
Excellent customer service and communication skills
Strong computer skills, including Microsoft Office Suite
Ability to manage multiple tasks and meet deadlines

Nice To Haves

Prior audit experience preferred
Insurance industry designations (e.g. INS, AIC, CPCU) preferred

Responsibilities

Conducts casualty-focused file reviews across Regional, Complex & Specialty teams
Measures handling quality against EMC Best Practices, Casualty KPIs, and state requirements
Performs targeted audits on specific casualty focus areas with stakeholders
Establishes audit standards and procedures with Claims/Casualty leadership
Documents findings, analyzes trends, and identifies improvement opportunities
Prepares and delivers audit reports, summaries, and presentations
Recommends process improvements and future audit focus areas
Communicates results and action plans to stakeholders
Supports implementation of new audit processes and continuous improvement efforts
Provides insights to drive consistency, accountability, and better claim outcomes
Conducts claims-wide audits with leadership and QA partners as needed
Adapts audit scope based on evolving business needs and priorities
Participates in training sessions and shares audit insights with teams
Assists with special projects, including guideline reviews and KPI-focused initiatives
Collaborates cross-functionally to ensure audit and project goals are met