Accuracy Improvement

Claims Quality Improvement Specialist

The Claims Quality Improvement Specialist will serve as a mentor and coach to the companies partnered with Accuracy Improvement.  Responsibilities include establishing and maintaining high standards of quality claims handling while working to identify opportunities for better claims processing with the ultimate goal of sound claims decisions to reduce exposure to litigation. The Claims Quality Improvement Specialist will also utilize data to assess effectiveness of procedures, examining overall file quality to ensure compliance with File Handling Guidelines. Files of both inside and field adjusting staff are to be evaluated to ensure integrity in core adjusting processes.

RESPONSIBILITIES

  • Review both inside and field adjuster files for coverage and estimate accuracy.
  • Work proactively with Accuracy Improvement management and adjusters creating resolutions to areas needing improvement.
  • Serve as the subject matter expert of the Estimating Guidelines and Quality File Handling Guidelines for the company claims assigned to be reviewed.
  • Assist in the identification and resolution of quality assurance issues.
  • Provide monthly audit data to claims management to assess trends for improvement of file quality.
  • Advise Accuracy Improvement management regarding potential training opportunities for the company being reviewed.
  • Manage special projects, as assigned, within the established time and quality guidelines.
  • Develop and maintain an open and trusting working relationships with the assigned company employees to effectively serve as a coach and mentor to the team.
  • Perform other related duties as assigned.

What You’ll Need to be a Top Candidate

Education: Chartered Property Casualty Underwriter (CPCU) certification, Bachelor’s degree from an accredited college or university, or an equivalent combination of education and experience. Experience: Seven to ten years prior experience as a Claims Adjuster and three to five years prior experience in claims quality assurance. Licensure: State specific adjusting licenses required (varies by assignment). IICRC certification preferred.

Skills:

  • Ability to evaluate damages, analyze facts and determine coverages.
  • Negotiation and investigation expertise.
  • Effectively communicate with a wide variety of technical, professional and consumer clients.
  • Advanced proficiency in Microsoft Windows and Office Suite experience.
  • Xactimate Level 1 required, Level 2 or 3 preferred.
Working Conditions: Must be able to remain in a stationary position for periods of time while constantly operating a computer and or other office productivity machinery such as a calculator or telephone.

Benefits:

  • Competitive salary
  • Flexible work hours
  • Learn about an exciting industry
  • Ability to work remotely
  • Be part of a team of motivated and talented individuals
Travel: Occasional travel for training purposes. Accuracy Improvement is an Equal Opportunity Employer. Submit your information below to work with the Accuracy Improvement Team

First name *

Last name *

Address *

City *

State *

Zip *

Email address *

Phone number *

Best time to contact *

Date available to start *

Years experience in claims adjustment *

Years experience in quality assurance *