Senior Claims Quality Auditor

Title 

Senior Claims Quality Auditor

Overview of Position

The Senior Claims Quality Auditor reviews both internal claim files and external Third Party Administered handled claim files using a standard form to confirm proper claims handling adherence to the Fair Claims Settlement Regulations set for by the Dept of Insurance as well as following specific proprietary claims handling instructions on service standards.  The audit is designed to be an accurate
assessment of the claims handling process providing results that identify strengths and opportunity areas where improvement is needed to safeguard the company’s interest. The auditor prepares a monthly summary report explaining deficiencies, issues, or inquiries concerning the claims handling process.

What will be my duties and responsibilities in this job? 

• Complete both internal adjuster & external TPA and IA handled open and closed claim file audits.

• Determine whether claims handling is aligned with the Fair Claims Settlement
  Regulations.

• Collaborate with management in accounting, billing, claims, and actuarial
  identifying risk and potential training opportunities discovered from audits.

• Prepares comprehensive reports as required by Clients, and business leaders
  and facilitates meetings with Clients, Actuarial, Accounting, Internal Audit, and
  internal Claims leadership on results identify trends and communicating
  necessary action plans needed to reduce regulatory risk and outcomes.

• Maintain and update all documents pertaining to audit form, controls, processes, job aids, and bulletins.

• Assists with internal audits (departmental expense audits, T&E audits, General
  Supplies audits, etc.)

• Act as the liaison to external Vendors as well as internal Vendors, Ethics, and
  Audit to help the groups work effectively with each other by answering questions effectively, resolving conflicts quickly, and encouraging collaboration.

• Serve as technical resource to both internal & external teams.  

What are the requirements needed for this position? 

• Adjusters License will be required in all states where adjuster licensing is applicable.  

• Minimum 5 years in property claims or equivalent related P&C insurance experience.

• P&C Claims adjusting experience to include a strong level of knowledge in adjusting claims and interpretation of policy coverage and provisions,
  exposures, evaluation of the compensability of the claim, departmental standards, and state laws governing compliance.

• Prior auditing experience. (May include Quality Audits, Fraud Assessment Audits, Financial Audits, Expense Audits. etc.)

• Strong working knowledge of all currently used estimating platforms (example Xactimate).

• Strong working knowledge of all currently used estimating platforms (example Xactimate).

• Excellent verbal and written skills to communicate internally and
  externally.

• Excellent critical thinking skills

• Strong organization and time management skills

What other skills/experience would be helpful to have? 

• College degree preferred

• Ability to multi-task in fast-paced environment.

What are the working conditions and physical requirements of this job?  

General office demands  

#LI-Remote

Pay Range:

Any posted pay range considers a wide range of compensation factors, including candidate background, experience and work location, while also allowing for salary growth within the position.

Expected application deadline is

If date is blank then this is a pipeline requisition, and we will continue to collect applications on an ongoing basis.

Helping People Thrive in a Connected World
Connect with us. Bring us your best work and your brightest ideas. And we’ll bring you a place where you can thrive. Learn more at jobs.assurant.com.

For U.S. benefit information, visit myassurantbenefits.com. For benefit information outside the U.S., please speak with your recruiter.

What’s the culture like at Assurant?
Our unique culture is a big reason why talented people choose Assurant. Named a Best/Great Place to Work in 13 countries and awarded the Fortune America’s Most Innovative Companies recognition in 2023, we bring together top talent around the world. Although we have a wide variety of skills and experiences, we share common characteristics that are uniquely Assurant. A passion for service. An ability to innovate in practical ways. And a willingness to take chances. We call our culture The Assurant Way.

Company Overview
Assurant is a leading global business services company that supports, protects, and connects major consumer purchases. A Fortune 500 company with a presence in 21 countries, Assurant supports the advancement of the connected world by partnering with the world’s leading brands to develop innovative solutions and deliver an enhanced customer experience through mobile device solutions, extended service contracts, vehicle protection services, renters insurance, lender-placed insurance products, and other specialty products.

Equal Opportunity Statement
Assurant is an Equal Employment Opportunity employer and does not use or consider race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, or any other characteristic protected by federal, state, or local law in employment decisions.

Job Scam Alert
Please be aware that during Assurant's application process, we will never ask for personal information such as your Social Security number, bank account details, or passwords. Learn more about what to look out for and how to report a scam here.