Senior Claims Quality Consultant

Amerisure Mutual Insurance•Irving, TX

16d•Hybrid

About The Position

Amerisure creates exceptional value for its partners, policyholders, and employees. As a property and casualty insurance company, Amerisure’s promise to our partner agencies and policyholders begins with a comprehensive line of insurance products designed to protect businesses, as well as the health and safety of every employee. With an A.M. Best “A” (Excellent) rating, Amerisure serves mid-sized commercial enterprises focused in construction, manufacturing and healthcare. Ranked as one of the top 100 Property & Casualty companies in the United States, we proudly manage nearly $1 Billion of Direct Written Premium and maintain $1.21 billion in surplus. Amerisure is currently recruiting for a Senior Auto/GL Claims Quality Consultant that can do a hybrid approach in one of our offices. This role will focus on our auditing for our auto and general liability side of the house. The ideal candidate will also possess the following skill set. Summary Statement Responsible for quality reviews of claim files, aligning with the company’s regulatory and quality framework, promoting adherence to claims handling best practices. This role plays a critical part in in maintaining quality standards, driving continuous improvement, and advancing best practices within the Liability or Workers Compensation lines of business. Additionally, the position serves as subject matter expert and offers technical claims guidance in a specialized capacity.

Requirements

Bachelor’s degree or equivalent work-related experience.
5 years commercial lines claims.
2 years quality assurance experience.
Demonstrated in-depth knowledge of claims processes and procedures, including coverage analysis, investigation, evaluation, and settlement.
Familiarity with regulatory requirements, litigation management, and industry best practices.
Strong analytical and problem-solving skills with a detail-oriented mindset.
Proficient computer skills required including Microsoft Office Suite.
Excellent communication, interpersonal, and presentation skills.
Excellent problem solving, critical thinking and decision making skills.
Proficiency in claims management systems (e.g., Guidewire, ClaimCenter) and quality/audit tools.
Ability to handle confidential and sensitive information.
Experience in a multi-jurisdictional claims environment.
Ability to travel up to 10%.

Nice To Haves

Experience with quality frameworks (e.g., Six Sigma, ISO 9001).

Responsibilities

Conduct regular file reviews and audits to assess compliance with internal guidelines, industry standards, and regulatory requirements.
Analyze and interpret key performance indicators and metrics to identify claims trends as well as opportunities for improvement.
Evaluate claim outcomes against best practices and collaborate with the Claims Management to offer constructive, objective feedback, including suggestions for enhancements, training, and corrective measures.
Partner with Claims leadership to support ongoing improvements and operational efficiency initiatives.
Maintain, and report on quality metrics, scorecards, and dashboards to track performance.
Confer reserve and settlement authority to claims staff within delegated authority.
Stay up to date on multi-jurisdictional legal developments and industry trends to ensure compliance and informed decision-making.
Provide reinsurance reports to ensure compliance with our reinsurance reporting guidelines.