Quality Reviewer

Crawford • Atlanta, GA

2d

About The Position

Reviews low severity property and/or casualty claims to ensure quality and compliance with client instructions and service level agreements. Investigates and analyzes quality trends, recommends solutions and ensures corrections are made. Responsibilities Conducts thorough and accurate testing of claims before submission to clients. Claims are primary focused on personal lines and large national accounts with some limited commercial assignments. Reviews and verifies claims information to ensure the proper processing in accordance with established quality standards. Reads and interprets customer and vendor specifications. Reviews transactions and compares to the source documents to resolve errors and provides proper feedback. Verifies corrected material and prepares quality assurance reports as appropriate. Analyzes claims and process trends and makes corrective recommendations. Assist in the identification of new procedures, methods and/or tools to improve the efficiency of the quality process. Provides analysis and consulting support for the development and support of adjusters in the field. Provides detailed feedback to service centers regarding trends and anomalies in the claim files. Continuous monitoring of process performance and reports performance to responsible management Remains up-to-date with QA industry standards, principles and practices. Continuing education and development of skills Upholds the Crawford Code of Conduct.

Requirements

• Bachelors degree or an equivalent combination of education and experience.
• Three years experience handling property and/or casualty claims with at least one year of audit/quality control experience.
• Excellent writing and verbal communication skills
• Strong analytical ability
• Attention to detail
• Must possess critical thinking, interpersonal, problem solving, teamwork, and organizational skills
• Demonstrates excellent work ethic and focus on work, tasks, priorities and improving the QA process.
• Must have or secure and maintain the appropriate license(s) as required by the state(s) at the adjuster level.
• Must complete continuing education requirements as outlined by Crawford Educational Services

Responsibilities

• Conducts thorough and accurate testing of claims before submission to clients.
• Reviews and verifies claims information to ensure the proper processing in accordance with established quality standards.
• Reads and interprets customer and vendor specifications.
• Reviews transactions and compares to the source documents to resolve errors and provides proper feedback.
• Verifies corrected material and prepares quality assurance reports as appropriate.
• Analyzes claims and process trends and makes corrective recommendations.
• Assist in the identification of new procedures, methods and/or tools to improve the efficiency of the quality process.
• Provides analysis and consulting support for the development and support of adjusters in the field.
• Provides detailed feedback to service centers regarding trends and anomalies in the claim files.
• Continuous monitoring of process performance and reports performance to responsible management
• Remains up-to-date with QA industry standards, principles and practices.
• Continuing education and development of skills
• Upholds the Crawford Code of Conduct.

What This Job Offers

• Job Type: Full-time
• Number of Employees: 5,001-10,000 employees