Claims QA Analyst

Heritage Insurance • Tampa, FL

33d

About The Position

This position is responsible for monitoring and reporting on Claims processes to ensure adherence to statutory compliance guidelines as well as established company performance and quality standards . Key Claim metrics are monitored, compiled, and communicated to maintain high quality standards.

Requirements

• HS or Equivalent, Some College Preferred
• Insurance Claims Handling Knowledge
• Proficiency with Microsoft Office programs required, Excel, Word and Outlook
• Demonstrated customer service focus
• Strong communication and interpersonal skills
• Results driven with strong problem solving and analytical skills
• Ability to work independently in a fast-paced environment; meet deadlines and manage changing priorities effectively
• Very detail-oriented
• Exceptional organizational skills
• Collaborative partner; ability to contribute to a positive work environment.

Responsibilities

• Maintains excel reports to document adherence to key quality metrics in areas such as adequate claim reserves, timely first contact, phone measurements, coverage explanations, Diary utilization, etc. The report data is compiled from emails and applicable company software systems.
• Sends timely email reminders and communication to ensure appropriate process and quality protocols are maintained throughout the claim cycle.
• Conducts claim file audit reviews for examiners as well as other quality assurance projects.
• Collects, analyzes, and reports data from the Claims system to supply analytical results to management to ensure we are meeting each measured SOX requirement, as well as ensuring we are following the Heritage best practices.
• Supports workload surges and/or Catastrophe operations as needed to include working significant overtime during designated CATs.
• May perform special projects or other duties and responsibilities as assigned.
• Communicates with co-workers, management and others as needed in a courteous and professional manner.
• Maintains the integrity of the company and products offered by complying with federal and state regulations as well as company policies and procedures.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Insurance Carriers and Related Activities
• Education Level: High school or GED
• Number of Employees: 251-500 employees