Senior Claims Quality Consultant jobs in United States
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Amerisure Insurance · 1 day ago

Senior Claims Quality Consultant

Amerisure Insurance is a property and casualty insurance company focused on providing exceptional value to its partners and policyholders. The Senior Claims Quality Consultant will be responsible for conducting quality reviews of claim files, ensuring compliance with regulatory standards, and driving continuous improvement in claims handling practices.

Financial Services
Hiring Manager
Beverly Rose
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Responsibilities

Conduct regular file reviews and audits to assess compliance with internal guidelines, industry standards, and regulatory requirements
Analyze and interpret key performance indicators and metrics to identify claims trends as well as opportunities for improvement
Evaluate claim outcomes against best practices and collaborate with the Claims Management to offer constructive, objective feedback, including suggestions for enhancements, training, and corrective measures
Partner with Claims leadership to support ongoing improvements and operational efficiency initiatives
Maintain, and report on quality metrics, scorecards, and dashboards to track performance
Confer reserve and settlement authority to claims staff within delegated authority
Stay up to date on multi-jurisdictional legal developments and industry trends to ensure compliance and informed decision-making
Provide reinsurance reports to ensure compliance with our reinsurance reporting guidelines

Qualification

Claims processes knowledgeQuality assurance experienceClaims management systemsRegulatory requirements familiarityAnalytical skillsMulti-jurisdictional experienceQuality frameworks experienceMicrosoft Office proficiencyCommunication skillsInterpersonal skillsPresentation skillsProblem-solving skillsCritical thinkingDecision makingConfidentiality handling

Required

Bachelor's degree or equivalent work-related experience
5 years commercial lines claims
2 years quality assurance experience
Demonstrated in-depth knowledge of claims processes and procedures, including coverage analysis, investigation, evaluation, and settlement
Familiarity with regulatory requirements, litigation management, and industry best practices
Strong analytical and problem-solving skills with a detail-oriented mindset
Proficient computer skills required including Microsoft Office Suite
Excellent communication, interpersonal, and presentation skills
Excellent problem solving, critical thinking and decision making skills
Proficiency in claims management systems (e.g., Guidewire, ClaimCenter) and quality/audit tools
Ability to handle confidential and sensitive information
Experience with quality frameworks (e.g., Six Sigma, ISO 9001)
Experience in a multi-jurisdictional claims environment
Ability to travel up to 10%

Benefits

Competitive base pay
Performance-based incentive pay
Comprehensive health and welfare benefits
A 401(k) savings plan with profit sharing
Generous paid time off programs
Flexible work arrangements to promote work-life balance

Company

Amerisure Insurance

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Amerisure is an insurance company that creates exceptional value for its agencies, employees and policyholders.

Funding

Current Stage
Late Stage

Leadership Team

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Kendall Clavin
Vice President of Underwriting
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K
Kevin Korte
Vice President of Workers’ Compensation
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Company data provided by crunchbase