Claims Quality Assurance Consultant (Hybrid/Remote)

Job Description

We currently have an opportunity for a Claims Quality Assurance Consultant on our Claims Operations team based hybrid in our Denver, CO or Canton, MA offices or remotely nationwide. The consultant would conduct claims quality audit reviews, closed file reviews and other file quality assurance activities contributing to the organization’s ability to efficiently handle and settle claims. Analyzes results and findings of campaigns, identifies trends and develops action plans and coordinates implementation of plans with various claims departments. Identifies and reports on file and segment specific opportunities for improvement as well as overall claim quality assurance issues and trends. Participates in all other claim audit and quality assurance activities as requested. **

Responsibilities**

• Participates in Closed File Review Campaigns and other file quality assurance activities contributing to the organization’s ability to efficiently handle and settle claims. Reviews claims individually and collaboratively in teams for consistency with Claims Best Practices, Technical Triggers, Claims Legal Triggers, and state regulations and other criteria.
• Analyzes, prepares and presents completed findings post campaign or other audit activity. Participates in the development of action plans regarding those results.
• Identifies trends and quality improvement opportunities through review of claims files across all business segments.
• Communicates as needed within Claims regarding trends. Provides expertise and insight as requested relative to needed changes or enhancements to Claims processes. Provides input and drafting support for updates and/or changes to corporate claim handling standards.
• Maintains a strong professional knowledge of claims regulatory and legal environments and applies this information effectively.
• May coach or train less experienced claim representatives; provides guidance to other claims departments, as needed.
• Participates in all other claim audit and quality assurance activities as requested.

Requirements:

• Must have superior analytical, negotiation, decision making, problem solving, organizational and presentation skills. Must be a proven self-starter with strong multi-tasking and relationship management skills.
• Must be able to communicate professionally and effectively including expert oral, written, and listening skills. Must be able to work both independently and as a member of a team and have the ability to interact with diverse groups of individuals.
• Must maintain a high level of accuracy and provide follow-through on projects.
• Requires the ability to maintain confidential information. Must be able to work in a fast pace and rapidly changing environment.
• Demonstrated proficiency with computer software including Microsoft Office suite and other Claims tracking tools.
• Must maintain strong professional knowledge of industry trends, legislative issues and the marketplace for associated line of business.
• Ability to travel, including internationally, on occasion for business purposes.

Education

• Bachelor’s degree or equivalent experience required.
• 7-10 years of progressively more complex, specialized claims handling experience, including coverage analysis, investigation and litigation.
• State Adjusting license
• Continuing education such as CPCU, AIC, SCLA or CCP designations preferred.

_Our salary ranges are determined by many factors including location, role, experience and skillset of the candidate. The following ranges displayed reflect the target base salary for new hires but your recruiter will share more specific compensation information with you during the hiring process. The typical base salary range for this position is: $106,000 – $140,000, based on the factors aforementioned. For candidates located in San Francisco, CA; Hoboken, NJ; and the New York City metro area, the base salary range is $123,000 -$144,000. In addition to base salary, full time Intact employees are also eligible for bonus potential and a full range of benefits to include: 401(k) savings and annual contributions of up to 12% of annual salary, competitive paid time off programs, medical, vision and dental plans, mental health support programs, life and disability insurance, paid parental leave and a variety of voluntary benefits.

_ Job Number

2424BR **

Division**

Claims **

Location**

Denver CO **

Location(s)**

Canton MA, Denver CO, Remote **

Country**

United States **

About Us**

At Intact Insurance Specialty Solutions we are experts at what we do. Our deep understanding of the specialty insurance market is the foundation for our customized solutions, backed by targeted risk control and claims services. Our employees are passionate about providing insurance coverage that’s aligned to our targeted customer groups. Today, we help protect over a dozen industries with tailored coverages and services.