Claims Quality Analyst
About The Position
The Claims Quality Analyst supports West Bend’s Claims Quality Assurance team by assessing casualty claim handling quality, compliance, and alignment with company best practices, policies, and adjusting procedures. The analyst reviews claim files, audit results, and performance trends to identify consistent strengths and opportunities for improvement, then provides objective, useful feedback to Claims leaders and teams. The role manages the audit database, selects and deploys files for review, develops reporting, and shares findings and recommendations. It also serves as a casualty claims resource for Claims and Training teams, supports reviewer guidance and calibration, provides technical guidance and coverage interpretation on low- to moderate-complexity issues, and contributes to targeted audits and special projects. The position may be remote or hybrid. Candidates residing within 50 miles of an office in West Bend, Madison, or Appleton are offered a hybrid schedule. Fully remote employees beyond 50 miles may occasionally be asked to travel to an office for team meetings, training, and corporate events.
Requirements
- 7 years of claims handling experience, including auto investigations, bodily injury, and general liability claims.
- 3 years of claims auditing experience.
- Experience working with complex or large claim files.
- Strong knowledge of regulatory requirements and insurance industry standards.
- Analytical ability to recognize meaningful patterns in audit results and claims data.
- Strong attention to detail while maintaining perspective on broader issues.
- Ability to explain complex claims concepts, findings, or data in a straightforward way.
- Strong communication skills and ability to work effectively with Claims professionals and leadership.
- Experience coaching, mentoring, or helping others develop technical knowledge.
- Comfort working with current technology, databases, and reporting tools.
Nice To Haves
- Bachelor’s degree in Communications, Education, Business, or a related field.
- Insurance designation such as CPCU, AIC, or AINS.
Responsibilities
- Review casualty claim files for quality, compliance, and adherence to West Bend’s best practices, policies, and adjusting procedures.
- Conduct claims performance reviews and analyze audit results to identify trends and areas for further review.
- Manage the audit database, select and deploy files for review, and develop reporting that explains audit results.
- Share findings and recommendations with Claims leadership clearly and practically.
- Serve as a casualty claims resource for the Claims and Training teams.
- Guide and calibrate reviewers to promote consistency throughout the audit process.
- Provide technical guidance and coverage interpretation on issues of low to moderate complexity.
- Build productive relationships with stakeholders across Claims and other areas of the organization.
- Conduct targeted audits, special projects, and reviews of emerging quality questions.
Benefits
- Medical and prescription insurance
- Health Savings Account
- Dental insurance
- Vision insurance
- Short- and long-term disability
- Flexible Spending Accounts
- Life and Accidental Death & Disability insurance
- Accident and Critical Illness insurance
- Employee Assistance Program
- 401(k) plan with company match
- Pet insurance
- Paid time off; standard first-year PTO is 17 days, prorated based on month of hire
- Enhanced PTO may be available for experienced candidates
- Performance-based bonus eligibility
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Senior
