Claims Quality Specialist

2 days ago

Fond du Lac, United States Society Insurance Full time
Job Information

Job Title

Claims Quality Specialist (Property Focus)

Home Department:

Claims

Employment Status:

Exempt; Full-time, Benefits Eligible

Schedule:

40 hours/week with Flexible Scheduling Opportunities

Position Location:

Home Office, Telecommuting, and Remote Opportunities

Overview

Protecting our policyholders' dreams, passions, and livelihoods has a direct impact on the communities we serve. We work towards excellence, conduct ourselves with high integrity, and take our work seriously, but not ourselves. Small Details. Big Difference. Find out how you can make a difference with a career at Society.

Society Insurance is seeking a Claims Quality Specialist (Property Focus) to join our Claims team. This Claims Quality Specialist will provide technical and instructional support to the claims team, including auditing and reviewing files. This role works closely with Claims leadership to improve the file quality of the claims staff while also ensuring the claims handling guidelines are followed and accurate.

About the Role
  • Audits property claim files, providing feedback and necessary reporting for improved claims handling.
  • Identifies areas for improved efficiencies based on audit findings, claim trends, and growth plans. Audits results shared with claims management along with significant collaboration on department and companywide initiatives.
  • Helps coach and mentor claim representatives in related activities based on findings from file reviews and audits.
  • Works with leadership, including the directors and claims managers, to identify and review losses with large or complex exposure.
  • Reviews open claims as needed and consults with the director/managers to ensure the claims are moving to a timely logical conclusion.
  • Assists claims managers with monitoring of regulatory and compliance requirements for each state or line of business; assists implementation of requirements and assists in presentation of training opportunities and meetings regarding file handling.
  • Assists Claims Manager with vendor relations including the identification of vendors, along with products necessary for the claims team, and works with the manager on the final selection.
  • Provides technical expertise to the cost-containment staff including the VP, supervisory staff, claims staff, and staff outside the claims department as necessary.
  • Understands regulatory environment in the states in which consulted claims take place. Assists in the monitoring of these regulations, compliance requirements, and trainings as needed.
  • Reviews data for trends to assist the claims management team in policy or procedural matters.
  • Assists in coordination of quarterly training on claims topics.
About You
  • You are composed and enjoy working with ambiguity.
  • You are customer focused and relate well to all kinds of people.
  • You are patient and practice attentive and active listening.
  • You set objectives and goals to reach deadlines.
  • You are personally committed to continual improvement.
  • You are a strong communicator.
  • You like taking a systematic approach in making process improvements.
  • You are organized and can manage multiple responsibilities.
What it Will Take
  • Bachelor's degree in business or related field OR at least 7 years of experience handling claims.
  • At least 5 years of experience in property claims.
  • Ability to obtain and maintain proper licensing prior to handling a state where Society requires it.
  • Familiarity with coverages, laws, and concepts.
  • Demonstrated ability to provide feedback to others.
  • Strong analytical and problem-solving skills.
  • Demonstrated writing, editing, and proofing skills with attention to clarity, grammar, and detail.
What Society Can Offer
  • Comprehensive Benefits Package: Salary with bonus plan; health, dental, life, and vision insurance
  • Retirement: Traditional or Roth 401(k) Defined Contribution Plan PLUS Profit-Sharing Plan
  • Work-Life Balance: Company-paid holidays; flexible scheduling; PTO; telecommuting options
  • Education: Career Coaching; company-paid courses; student loan and tuition reimbursement
  • Community: Charitable Match; paid volunteer time; team sponsorships
  • Wellness: Employee Assistance Program; wellness initiatives/rewards; health coaching; and more

Society Insurance prohibits discrimination and harassment of any type against applicants and employees on the basis of race, color, religion, sex, national origin, age, handicap, disability, genetics, veteran status or military service, marital status or sexual orientation, gender identity or expression, or any other characteristic or status protected by federal, state or local laws. Society Insurance also provides reasonable accommodations to qualified individuals with disabilities in accordance with the requirements of the Americans with Disabilities Act and applicable state and local laws.

Society Insurance is a drug-free workplace. Any candidate who receives an offer of employment from Society will be required to undergo a pre-employment drug test for controlled substances. All offers of employment are contingent upon successful completion of the pre-employment drug test, which is conducted in accordance with Society's substance abuse policy.

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