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Litigation & Claims QA

3 months ago


Boca Raton, United States Florida Peninsula Insurance Company Full time

The Litigation and Claims Quality Assurance (QA) Analyst is responsible for completing tasks in support of FPM CQA objectives. This positions primarily function is to conduct systematic quality file reviews of residential property claims involving the handling of litigation, field, and claim operations in accordance guidelines and best practices. The Litigation and Claims QA Analyst also trends from file reviews and recommends improvement opportunities for Litigation, Field, and Claims Department training. Assists with training efforts as requested.

Completes open, closed, and double claim file reviews in compliance with established CQA processes and procedures for Litigation, Field, and Claims Adjusters. Participates in root cause analysis (5 why's, Kepner-Trego, Fishbone, etc.) Complete ad hoc file reviews to determine extent of issues identified as requested Participates in process improvement efforts to assist with efficiency, development, and implementation of new litigation/claims processes and procedures to ensure compliance with CQA standards Performs process and procedure training - serves as subject matter expert resource in support of training efforts as requested Participates in roundtable weekly discussions as a litigation/claims subject matter expert; identify areas for improvement/training opportunities Complete post-review follow-up items as requested Reviews litigation/claims departmental materials prior to rollout as requested Other duties as assigned, with or without accommodation Present a professional, transparent, and helpful philosophy Assist in other department areas as requested #LI-Remote