INTERNAL CANDIDATES ONLY- QA Specialist

RYZE Claim Solutions

About The Position

The QA Specialist leads quality review operations by sourcing, onboarding, supporting, and auditing a network of independent 1099 reviewers. The role defines the rules that the QAi tool checks on each claim and serves as the account expert and client escalation point. The specialist uses judgment to establish quality standards, evaluate whether work meets those standards, and determine how files are assigned. Direct file reviews are completed only after leadership responsibilities are handled, and not during busy periods. The role includes assigning work across the reviewer network to meet carrier deadlines, including during peak periods; auditing completed work and providing feedback; managing account knowledge; and working with IT to define QAi rules. When handling a file, the specialist updates estimates based on carrier rules and provided photos, using an active license in the relevant state and the carrier's preferred system, such as Xactimate. The role manages quality and cycle time rather than cost and requires availability during core business hours and peak periods.

Requirements

Strong quality judgment on residential property claims.
Working knowledge of carrier guidelines and account requirements.
Estimating skill in Xactimate or the carrier's preferred system.
An active adjuster license.
Comfort auditing work product and giving quality feedback to independent reviewers.
Ability to use data to assess quality and time in process.
Clear communication and accountability with clients, leaders, and 1099 reviewers.
Interest in how rules and systems drive automation.

Responsibilities

Source and vet independent 1099 reviewers in coordination with leadership and recruiting, including confirming their licenses and qualifications.
Create and maintain onboarding materials covering carrier guidelines, account requirements, and quality standards.
Answer independent reviewers' questions about carrier guidelines and account requirements.
Audit completed work from independent reviewers against quality standards and provide feedback on deliverables.
Use quality and turnaround data to determine file assignments, offer additional files, or end an engagement.
Offer and assign files across the reviewer network to meet carrier deadlines, including during busy periods.
Define the rules QAi checks on each claim in collaboration with IT, which builds and configures the tool.
Act as the knowledge expert for assigned accounts, including carrier guidelines, authority limits, and preferred systems.
Serve as the client escalation point for files.
Update estimates based on carrier rules and provided photos, using the appropriate state license and carrier-preferred system.
Complete file reviews after other leadership work is done, reviewing none during busy periods and potentially reviewing during slow periods or on tight timelines.
Track processes and task completion time, managing quality and cycle time rather than cost.
Remain available during core business hours and peak periods to respond to reviewer questions and client escalations.