Senior Quality Assurance Analyst

Role Overview

• 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, insurance carrier criteria and follows and enforces Aspire General Insurance Company/partner’s policies, procedure 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.

Requirements

• Four plus years’ experience in 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 practice and claim processes.
• Excellent interpersonal, written, and verbal communication and problem resolution skills.
• Proficient information systems understanding and skills, to include 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 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, strong interpersonal and customer service skills.

Benefits

• Medical
• Dental
• Vision
• HSA*
• PTO
• 401k
• Company Observed Holidays