Claims - Quality Assurance Specialist

US-TN-Nashville
Job ID
2017-7356
Category
Claims Service/Support
Type
Regular Full-Time

Overview

The primary duties of the Quality Assurance Analyst are to coordinate, plan and perform claims file audits including Departmental as well as focused audits for financial, operational, compliance, or specific claim types.  Effectively work with external and internal compliance auditors and have the ability to be involved in more than one audit at a time.  The QA Analyst is to manage a variety of claims software systems and administer a number of key data controls within the claims department to ensure processes and procedures are accurately being followed. Additionally, QA Analysts will identify areas of opportunity or process gaps and provide recommendations for improvement and/or training.

 

As a Team Member at Acceptance Insurance, you will be part of growing organization that continues to evolve and positively impact the lives of our customers.

 

Acceptance Insurance offers a full line of benefits including: Health Insurance, Dental, Vision, Paid Vacation, Disability Insurance and Employer Matching 401(k) Program.

 

Company Overview:

We are principally a retailer, servicer and underwriter of non-standard personal automobile insurance based in Nashville, Tennessee. Our insurance operations actively generate revenues from selling non-standard personal automobile insurance policies and related products in 16 states. We currently conduct our servicing and underwriting operations in 13 states and are licensed as an insurer in 13 additional states.

 

At March 31, 2017, we leased and operated 355 retail locations and a call center staffed with employee-agents. Our employee agents primarily sell non-standard personal automobile insurance products underwritten by us, as well as certain commissionable ancillary products. In most states, our employee-agents also sell a complementary insurance product providing personal property and liability coverage for renters underwritten by us. In addition, retail locations in some markets offer non-standard personal automobile insurance serviced and underwritten by other third-party insurance carriers for which we receive a commission. In addition to our retail locations, we are able to complete the entire sales process over the phone via our call center or through the internet via our consumer-based website or mobile platform. On a limited basis, we also sell our products through selected retail locations operated by independent agents. 

 

 

Learn more:

Visit us at www.acceptanceinsurance.com

Responsibilities

  • Conduct Claim file audits to ensure file handling is in compliance with industry best practices
  • Effectively plan each audit including audit date range and communicating audit scope to appropriate parties.
  • Keep the appropriate parties advised of the status of the current audit results while recognizing and communicating trends, training needs, compliance requirements or process reviews required.
  • Perform effective wrap-up meetings with the appropriate parties specifically identifying any follow up activity such as training, communication updates, compliance, and process review requirements.
  • Complete follow-up audits as necessary to determine whether deficiencies are corrected.
  • Assist vendor billing and validation
  • Maintain quality metrics and scorecards
  • Identify and synthesize areas of opportunity and process gaps and provide recommendations to Claims leadership and/or Training & Development
  • Complete special projects at the direction of the Director of Quality Assurance or Claims Leadership
  • Participate and provide constructive feedback in Claims roundtable meetings
  • Stay current with industry best practices as well as process improvements and provide appropriate guidance and insight to the Claims organization
  • Other duties as assigned.

Qualifications

Qualifications & Skills:

  • Possess a track record of excellent performance
  • Solid understanding of Claims best practices
  • Exceptional attention to detail
  • Team player demonstrating strong collaborative orientation with the ability to build strong relationships across the organization
  • Ability to multi-task in a fast-paced environment while meeting critical deadlines
  • Proficient in the use of MS Excel and Word
  • Desire to assume greater responsibilities
  • Desire to stretch beyond current skills or role
  • Business results focused
  • Willingness to be flexible and mobile for career advancement
  • Capable of success with strategic level responsibilities
  • Understanding of applicable statutes, regulations and case law.
  • Strong understanding of Acceptance Insurance policy forms

Years of Experience Requirements

  • Minimum of (3) years of claims handling experience preferably with a strong focus in bodily injury and material damage handling.

 Education Requirements

  • High School Diploma required
  • 4 Year College Degree preferred

Competencies Required

  • Demonstrated creative problem solving and critical thinking/decision making skills
  • Demonstrated strong interpersonal skills
  • Demonstrated analytical and technical skill strength
  • Demonstrated verbal and written communication skill strength
  • Demonstrated functional and technical competency

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