Claims Quality Assurance Analyst

Job Description

Subject Matter Expert and skill set mastery in Auto and/or Property Claims handling. 

Provides technical assistance and training to claims staff as necessary, and facilitates audits on a regular basis, as directed by the Quality Assurance Manager. 

Audits claim representatives and independent partners’ claims by utilizing the current auditing system.   Utilizes the audit results to identify training needs on an individual basis for each team member.  Reviews the audit findings with Quality Assurance Manager to provide timely feedback.

Conduct on-site Direct Repair Facility audits to verify all repairs were completed according to the final bill and related to the claim. 

Conduct on-site Property Re-Inspection audits to verify quality and accuracy, verify completed repairs, and serve as a liaison with policyholders to ensure proper customer service for all claims to include; storm claims, Independent Appraiser, daily field claims, vendors, and random audits as determined. 

Conduct adjuster quality reviews; in field, in office, by desk, and Ride-a-longs, to evaluate and implement quality assurance standards, gauge adjuster knowledge, determine proper utilization of Best Practices, and overall claims handling quality.

Assist in preparing and monitoring monthly statistical Quality Assurance reports with data collected from reviews of all Adjusters and Customer Service Reps in the Claims Department. 

Requirements:

  1.       Bachelor’s degree from an accredited college or university preferred

  2.       Minimum of 7 years experience in property and/or auto claims, and

  3.       5 years experience in a Quality Assurance role, with emphasis in either auto or property, or both. 

  4.       Possess a current Texas Adjuster All Lines or Property/Casualty License.