Sr. Claim Quality Assurance Director
Sr. Claim Quality Assurance Director
Employer Active
Job Alert
You will be updated with latest job alerts via email
Share
Job Alert
You will be updated with latest job alerts via email
Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
Position Overview:
As a member of the Claims Quality Assurance Team a person in this position is responsible for supporting continuous improvement by measuring aggregate also include partneringwith various levels of internal and external claims management to analyze and communicate findings to underwriting regional management claims management and actuarial business partners. This position reports to a Quality Assurance and Compliance Team manager.
Roles and Responsibilities:
- Assists in the selection of aggregate accounts on an annual basis and develops a workflow for completing necessary tasks within the allotted timeframe provided by underwriting.
- Performs a thorough analysis of reserve adequacy for specifically designated Chubb Global Casualty and Construction accounts evaluates results and translates findings into key areas of focus for the account and/or Third-Party Administrator.
- Collaborates and functions as a liaison with various internal underwriting branch managers and underwriters. This position will determine if there are any known issues with an account and use relevant information to determine the approach for a specific aggregate review.
- Collaborates with claim management in the development of meaningful action plans that detail the tasks resources and timeframes necessary to improve claim handling when relevant.
- Leads aggregate reviews including pre-work such as file selection and communication assuring the review process is proper and timely and reporting at the conclusion of the review.
- Provides training to Chubb managers in the use of the quality review tool for results and analysis and Dashboard training to the field.
- Interact with multiple business partners (Underwriting Claims Internal Audit TPAs and Accounts as required.
- Strong contributor to the team shares ideas corrective actions or other QA collateral with the QA team and across claims units inclusive of Quality Assurance Reviews for TPAs and internal reviews.
- Stays current within respective field(s) of expertise jurisdictional changes and relative licensing.
Qualifications
Skills and Experience:
- Knowledge of Insurance Industry and Claims Handling (TPA and Carrier perspective)
- Technical knowledge of the Workers Compensation line of business.
- Excellent interpersonal written and verbal communication and problem resolution skills.
- Proficient information systems understanding and skills to include Microsoft Office programs (Word Excel Access and Power Point) and the internet.
- Ability to collect dissect and analyze complex data sets to identify root causes/trends.
- Ability to provide consultation and advice to management on aggregate trending.
- Ability to excel independently and in a team environment.
- Excellent time management and organizational skills.
- Strong background in Insurance Operations preferred.
Qualifications:
- Bachelors degree in related field or proven insurance related experience.
- Multiple jurisdictional claims handling experience.
- At least 5years of experience in Workers Compensation.
- Insurance designation preferred.
Required Experience:
Director
Employment Type
Full-Time
