Senior Claims Quality Analyst
About The Position
The Quality Improvement job family serves the claims operation in a variety of capacities, most of which are carried out through specialized, technical expertise. The primary functions of this job family are comprised of quality claim audits and quality assurance to maintain claims guidelines, consistent processes, level of quality, etc., of internal staff and external vendors. These jobs may also perform estimate reviews and/or do full reinspection. In other cases, these jobs may be responsible for assisting analyst, specialist, the department, and/or other high-level positions that handle operational functions of the business area. Other key functions of the Quality Improvement job family may be improving process and procedures while maintaining technical bulletins, procedures, policies, practices, guidelines, and official records for the business area.
Requirements
- Minimum of four years of direct property claims handling experience, with emphasis on complex, high‑severity commercial property losses
- Two to four years of hands‑on experience using Xactimat
Nice To Haves
- Bachelor’s degree in a related field
- Field claims experience with property inspections and estimate preparation
- Experience handling liability claims
- Familiarity with Guidewire and Athenium auditing platforms
Responsibilities
- Conduct and document claim audits in the designated audit system within established timelines, completing a minimum of three claim file audits per day.
- Evaluate claim files for coverage, liability, estimates, reserving, documentation, and compliance with internal standards, regulatory requirements, and quality expectations.
- Review property estimates for accuracy, completeness, and adherence to guidelines, and identify potential leakage or missed cost controls.
- Analyze audit results and perform focused audits on specific trends as needed to identify gaps and opportunities for improvement.
- Provide clear and constructive feedback to claims staff and leadership.
- Escalate critical findings and provide immediate feedback to leadership when urgent action is needed on a claim.
- Participate in internal calibration activities within the Quality team to ensure scoring consistency.
- Partner with leadership to support training initiatives and process improvements.
Benefits
- health
- dental
- vision
- 401(k) with company match
- paid time off
- professional development opportunities
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
