Claims Quality Assurance Manager

Hiscox•Chicago, IL

3d•Hybrid

About The Position

The Claims Quality Assurance Manager leads the claims quality assurance program across Hiscox’s internal and third-party administrator operations. The role is accountable for the quality framework, risk-based review strategy, team performance, stakeholder reporting, and delivery of sustainable improvements. The manager partners with Claims Leadership, Compliance, Legal, Operations, and business units to ensure regulatory requirements and Hiscox Claims Best Practices are consistently applied. The role sits within the Quality Assurance & Governance team, a group of professionals with operational and technical expertise that supports claims quality assurance and governance across Hiscox. The team promotes standardized processes, calibration, and ongoing development in claims handling, while responding to evolving stakeholder needs. As part of the Claims Quality Assurance Centre of Excellence, the role offers exposure to a variety of insurance products and collaboration with business leaders across the organization. The position is based in Atlanta or Chicago and is hybrid, requiring two days in the office each week. It is permanent and full-time. The salary range is $100,000–$130,000, with actual pay determined by factors including role scope, complexity, location, and the candidate’s skills, education, training, credentials, and experience.

Requirements

10+ years of progressive multi-line claims experience, including significant responsibility for claims quality assurance, auditing, compliance, or operational risk.
Demonstrated experience leading, coaching, and developing a team, or providing sustained functional leadership across a quality assurance program.
Deep knowledge of claims handling practices, regulatory expectations, state DOI standards, compliance, and operational risk.
Experience working collaboratively across multiple internal and external teams, including third-party administrators and suppliers.
Ability to build effective relationships and influence stakeholders at all organizational levels, with strong facilitation, written, and verbal communication skills.
Ability to analyze complex review findings and data and translate them into executive-level insights, risk assessments, and actionable recommendations.
Sound judgment, strong organization, and change leadership, with the ability to balance competing priorities, respond to emerging risks, and take a pragmatic, commercial, customer-focused, and solution-oriented approach.
A strong track record of driving corrective action, improving processes, and reducing repeat quality deficiencies.

Nice To Haves

Demonstrable subject-matter expertise in claims quality, technical claims handling, or regulatory compliance.
Experience designing or enhancing quality frameworks, audit methodologies, governance arrangements, or management reporting.
Experience overseeing TPA quality, vendor performance, or delegated claims arrangements.
Experience in General Liability, Professional Liability, Property/Inland Marine, or other specialty lines.
A relevant professional designation in insurance, claims, audit, or compliance.

Responsibilities

Set the annual claims quality assurance strategy, review plan, methodology, and risk-based priorities across internal and TPA claims operations.
Lead, coach, and develop the Claims Quality Assurance team; establish objectives, allocate work, calibrate assessments, and maintain consistent, high-quality output.
Own the quality assurance framework and governance standards, aligning them with Hiscox Claims Best Practices, TPA Claim Handling Guidelines, regulatory obligations, and operational risk requirements.
Oversee monthly and thematic claim reviews, ensuring appropriate coverage, timely completion, sound evidence, and defensible conclusions.
Deliver concise management information and executive reporting that identifies trends, root causes, emerging risks, and priorities for corrective action.
Present findings and recommendations to Claims Leadership and key stakeholders, communicating risk, business impact, ownership, and required decisions.
Partner with business leaders to establish corrective action plans, assign accountability, monitor delivery, and verify sustainable remediation.
Drive calibration, training, and continuous improvement initiatives informed by review outcomes, regulatory developments, complaints, litigation, and other quality indicators.
Maintain effective governance, documentation, issue escalation, and quality controls across the end-to-end review process.
Serve as the senior point of contact for claims quality assurance matters and provide practical, commercially balanced advice to leaders and stakeholders.
Monitor program effectiveness through performance and risk indicators, adjusting priorities, resources, and review coverage as needed.

Benefits

Competitive salary and bonus based on personal and company performance.
401(k) with competitive company matching.
Comprehensive health insurance, vision, dental, and FSA plans, including medical, limited-purpose, and dependent-care plans.
Company-paid group term life, short-term disability, and long-term disability coverage.
Paid parental leave.
Four-week paid sabbatical after every five years of service.
Financial Adoption Assistance and Medical Travel Reimbursement Programs.
Annual reimbursement up to $600 for health club membership or fees associated with a fitness program.
Dynamic, creative, and values-driven culture.
Modern and open office spaces and complimentary drinks.