FreshRemote.Work

Sr. Claims Quality Assurance Analyst

Remote (United States)

Aspire General Insurance Company and its affiliated general agent, Aspire General Insurance Services, are on a mission to deliver affordable specialty auto coverage to drivers without compromising outstanding service. 
Our company values can best be described with ABLE: to always do the right thing, be yourself, learn and evolve, and execute. Join our team where every individual takes pride in driving their role for shared success.

About the role

  • Under the direction of the QC Management, the Sr.  Claims Quality Assurance Analyst will serve as an integral role within the claim’s organization, helping to drive operational efficiencies and improve claim handling by providing insights regarding claim handling, compliance, and customer service. The Sr.  Claims Quality Assurance Analyst is responsible for working collaboratively with members of the claims department and management across the organization while continuously supporting the improvement of the technical quality of the claims product while measuring compliance through the completion of quality reviews. The Sr.  Claims Quality Assurance Analyst will partner with various levels of claims management to analyze and communicate findings, recommend solutions, and assist in the development of meaningful action plans. 

What you'll do

  • Conduct quality audit file reviews.
  • Participate in or lead various claim projects or targeted audits.
  • Assist in the sharing and distribution of best practices through written reports, PowerPoint presentations, oral presentations, and various reporting platforms.
  • Lead or facilitate the calibration process for claim managers and the audit team.
  • Monitor, analyze, and improve claims performance in all areas including loss control, LAE, customer satisfaction, associate engagement, and development.
  • Actively participate in the development and implementation of any company customer satisfaction surveys or net promoter scores;
  • Complies with state and federal laws, Department of Insurance criteria, and insurance carrier criteria and follows and enforces Aspire General Insurance Company/partner’s policies, procedures, and work rules;
  • Performs a thorough analysis of quality review results and translates results into key opportunity areas. 
  • Assist in the development and maintenance of claim procedure manuals and training manuals.
  • Work with all levels of claims staff to ensure that the claims department is functioning at its best level of performance.
  • Identify the need for technical improvements in any system used by the claims department and work with I/T in the development of those system enhancements.
  • Actively participate in enhancements and serve as an agent of change in the development and enhancement of Aspires’ best practice guidelines.
  • Perform ad hoc auditing depending on the needs of the company.
  • Assist in testing processes, procedures, systems, and reports.
  • Actively participate in training claim handlers on technical claims content and analysis of audit findings. 
  • A strong contributor to the team, sharing ideas, corrective actions, or other QA collateral with the AQ team and across the claim organization. 
  • Stay current on compliance laws and insurance regulations in multiple jurisdictions. 
  • Interact with multiple business partners as required. 
  • Ensure ongoing adjudication of claims within company standards and industry best practices and regulations.
  • Support Aspires’ ongoing digital and process enhancements, providing innovative solutions for utilizing data management.
  • Produce grammatically correct and clearly written correspondence including letters, memos, reports, and claim file documentation.

Qualifications

  • Four plus years experience in the Property and Casualty insurance industry (Non-Standard Preferred)
  • Knowledge of Insurance industry and claims handling trends, compliance, and law 
  • Expertise in technical knowledge of Property and Casualty claim handling. 
  • Supervisor or management experience preferred.
  • Thorough knowledge of Aspires’ best practices and claim processes. 
  • Excellent interpersonal, written, and verbal communication and problem-resolution skills. 
  • Proficient information systems understanding and skills, including Microsoft Office programs and the internet. 
  • Ability to dissect QA data elements, identify root causes/trends, and quantify the “cost of non-compliance”. 
  • Ability to provide consultation and expert advice to management. 
  • Ability to excel independently and in a team environment.
  • Must be a self-starter and have the ability to work independently. 
  • Must be able to effectively manage time, projects, and resources. 
  • Must have a clear understanding of insurance industry practices, standards, and terminology.
  • Experience handling subrogation, property damage, and injury claims is required.
  • Must be able to pass a background check. 
  • Must have the ability to work in a high-volume, fast-paced environment while managing multiple priorities.
  • Must have a disciplined approach to all job-related activities.
  • Must have a solid foundation of personal organization, sound decision-making and analytical skills, and strong interpersonal and customer service skills.
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Job Profile

Regions

North America

Countries

United States

Restrictions

Fully remote within the United States

Benefits/Perks

Fully remote

Tasks
  • Analyze and communicate findings
  • Conduct Quality Audits
  • Develop action plans
  • Lead claim projects
  • Monitor claims performance
  • Participate in training
Skills

Auditing Claims management Compliance Customer service Data analysis Insurance Regulations Presentation Process Improvement Quality Assurance Report Writing

Experience

4 years

Timezones

America/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9