Claims Quality Data Analyst

AAA-The Auto Club Group•MI-Admin Office Building (AOB), MI

4d•Remote

About The Position

Serve as the Claims Quality data and reporting liaison regarding claim file audit deployment and data analysis. Ensures consistency and reliability in activities related to audit file deployment, tracking and reporting including smooth distribution of monthly assignments for all audit types. Act as the subject matter expert on the rules and processes used to assign and distribute monthly audits.

Requirements

College coursework or equivalent
Three years of experience in data analysis or data processing
A valid driver's license is required if the primary responsibilities of the role involve conducting in-person inspections or frequent in-person meetings with members.
Analyzing data to prepare reports
Utilizing computer software applications (e.g. Word, Excel, PowerPoint, Power BI, SharePoint, google cloud platform) to format data bases, write queries, generate reports, etc.
Prioritizing work assignments
Coordinating and controlling data-related projects
Designing and summarizing data
Identifying, researching and resolving moderate to complex business problems
Business planning and consulting to meet reporting needs across the claim's organization
Format and prepare reports
Communicate effectively in a work environment
Explain statistics and interpret data
Prepare and present reports and recommendations
Work in a team environment
Perform a variety of concurrent activities
Strong interpersonal, communication skills, including report preparation and presentation also investigative, analytical skills
Understand claim handling procedures and the complete claim lifecycle

Nice To Haves

Demonstrate strong experience in Tableau or other related tools
Developing or using software to develop predictive models
Analyzing and summarizing data with Tableau or a similar tool
Project planning/management including research and analysis and delivery
Experience/exposure to quality audit practices, internal controls and implementation of quality standards within an insurance or related industry
ACG claims policies and procedures, terminology and processing systems
Claims policy provisions, principles and concepts
Data modeling for Six Sigma or other similar projects

Responsibilities

Compiles data and identifies differences for leads to conduct meetings for coaching and performance of auditors
Participates in the development of dashboards to drive data-driven decision making and to identify file quality trends and patterns
Analyzes data to identify problems with audit deployment, audit set up and activation
Visualizes data with graphs, infographics and other methods
Ensures monthly claim quality file review deployments are balanced for all business lines including auditors and managers according to preset criteria and qualifications
Validates accuracy of Loss Run Data Files for all companies and all business lines and ensures timely receipt, accurate data and proper file distribution
Generates manual audits for any reviews required, including sample selection, deployment and drafting attachments for reports
Utilizes the claim file quality audit tool to improve reporting and analytic outputs and data presentation
Monitors, adjusts and manages business rules for audit deployment on a monthly basis
Manages internal requests to add and remove files from the sample following business rules and guidelines
Troubleshoots various levels of issues between vendor and ACG with audit deployments, reports, etc.
Obtains data from vendor systems and compile spreadsheets for vendor to assign manual audits on a monthly basis for PD Field, Total Loss and Litigated claims
Trains new managers on reporting functions of the claim audit tool
Assigns Work Product Quality and Calibration reviews for the audit teams
Functions as a liaison between the audit team and the managers conducting audits regarding audit deployment and reporting
Functions as a liaison between auditors and the audit tool vendor on design and deployment
Generates custom reports upon request