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Manager, Claims Quality Assurance
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Manager, Claims Quality Assurance
Alpharetta, GA, USA * Chapel Hill, NC, USA * Raleigh, NC, USA * Richmond, VA, USA * Scottsdale, AZ, USA * Virtual
Req #114
Wednesday, June 5, 2024
Come grow with James River Insurance
James River Insurance is an excess and surplus lines segment of James River Group Holdings, Ltd. and operates on an approved non-admitted basis in 50 states and Washington, DC. Since 2003, James River has provided thousands of commercial property and casualty customers with innovative and creative solutions for particular insurance needs.
At James River Insurance, we are committed to providing a stable and rewarding work environment supported by our Core Values and Guiding Principles: Integrity, Accountability, Innovation, Customer Service, Communication, and Teamwork.
We are proud of our recent national recognition as a 2023, 2022, and 2021 Top Workplaces USA awards.
James River Group Holdings, Ltd. is a Bermuda-based insurance holding company which owns and operates a group of specialty insurance and reinsurance companies. The Company operates in two specialty property and casualty insurance segments: Excess and Surplus Lines and Specialty Admitted Insurance. The Company tends to focus on accounts associated with small or medium-sized businesses in each of its segments. Each of the Company's regulated insurance subsidiaries are rated "A-" (Excellent) by A.M. Best Company.
Job Summary
The Manager, Claims QA is a self-starter who is passionate about driving excellence and continuous improvement. The Claims QA Manager is responsible for assuring the Claims Department is adhering to established best practices by evaluating claim handling performance and creating impactful training that drives professional growth and exceptional service. The Claims QA Manager will build and manage a team of quality assurance professionals providing guidance coaching and oversight to enhance work product.
This position collaborates closely with Claim Leadership to achieve excellence in service quality, improve claim outcomes and foster continuous improvement.
Duties and Responsibilities
Continuously exhibit and uphold Core Values of Integrity, Accountability, Communication and Teamwork, Innovation and Customer Service
Responsible for leading the quality and learning and development functions within the Claims department
Analyze and audit claims to ensure accurate coverage analysis, investigation, valuation, reserving, and disposition of claims
Work with Claims Leadership to refine, update and maintain Claims best practice guidelines
Partner with internal stakeholders to ensure the efficacy of the Claims audit program
Manage the Claims quality assurance program
Monitor Claim Professional training to maintain licensing
Develop and deliver Claims learning and development programs to improve job performance effectively and efficiently within the Claims department
Ensure learning and development programs support overall cadence and tenor of enterprise training and development programs by partnering with the Human Resources department
Analyze data on the effectiveness of Claims training programs and reporting the ROI of training and development initiatives
Develop and maintain library of training materials and tools
Ensure that project and department milestones and goals are met
Interview, select and train new employees
Guide and help team members with project issues
Responsible for continued development of Claims best practices and procedures
Track employee performance and provide regular and appropriate feedback
Provide employee feedback through regular check-ins and writing and delivering performance reviews
Lead team through obstacles and time constraints to overcome barriers and successfully deliver results
Knowledge, Skills and Abilities
Advanced knowledge of claims handling principles and best practices
Advanced knowledge of multiple P&C lines of business
Advanced knowledge and experience managing claims and litigation process
Ability to work on assignments that require a high technical level of expertise due to complexity and exposure, under minimal supervision
Ability to stay current on emerging trends in learning design and development
Ability to convey both technical and conceptual material in a clear and concise manner
Excellent written and verbal communication skills
Ability to develop an operation plan that aligns with and supports the overall business goals
Ability to provide insights and recommendations from quantitative and qualitative data
Ability to identify and make process and procedure improvement recommendations
Ability to demonstrate business acumen and forward thinking-skills
Ability to lead, motivate, influence, and mentor staff
Ability to set clear expectations, effectively monitor progress, provide constructive feedback and guidance, and hold staff accountable
Excellent organizational skills
Ability to effectively communicate with all levels of the organization
Advanced proficiency in MS Office (Word, Excel, Outlook)
Ability to travel occasionally
Experience and Education
Bachelor's Degree in related field required
Minimum seven years' insurance claims/financial services/customer service industry experience required
Three years' experience with program instructional design, development and delivery, adult learning, continuing education preferred
Three years' experience with insurance/financial service/customer service quality assurance preferred
Minimum of two years of people management experience preferred
Other details
Job Family
Claims
Job Sub Family
Operations
Pay Type
Salary
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