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Claims Quality Assurance Specialist
2 months ago
What We Provide
- Comprehensive health benefits, including medical, vision, and dental plans.
- 401(k) retirement plan with company matching contributions.
- Participation in the company profit-sharing program.
- Generous paid time off and holiday leave.
- Paid parental leave for new parents.
- Access to mental health resources through Headspace at no cost.
- Two complimentary on-site fitness facilities.
- Employee Assistance Program for personal support.
- Opportunities to join Employee Resource Groups.
- Programs for personal and professional growth.
Position Overview
The Claims Quality Assurance Specialist within the Quality Assurance Division is tasked with conducting thorough and precise audits of job files to ensure compliance with client specifications. This role requires adaptability, particularly regarding overtime and holiday work, especially during peak audit periods.
Key Responsibilities
- Evaluate estimates in accordance with carrier protocols.
- Ensure timely and equitable management of estimate review cycles.
- Scrutinize documents for thoroughness, precision, and adherence to carrier standards.
- Leverage current technology to assess and interpret written data and damage estimates.
- Achieve a minimum review of 40 claims daily across various stages of the claims process.
- Demonstrate strong analytical and mathematical skills.
- Utilize objective judgment and critical thinking to address challenges.
- Document and follow up on discrepancies found in files.
- Participate in training sessions, team meetings, and collaborative projects as required.
- Share knowledge and support colleagues when necessary.
- Deliver exceptional customer service.
- Communicate effectively with franchises via phone, email, and internal systems to accurately record claim information.
- Represent the organization with professionalism and integrity.
- Maintain an expected caseload and achieve a 95% average on departmental scorecards throughout the year.
- Assist the Franchise Support Phone Group as needed.
- Support the Billing Disputes process when required.
- Help resolve customer complaints as necessary.
Qualifications Required
- Proficient in reading, writing, and speaking English to communicate clearly with employees, customers, and suppliers.
- A minimum of two years of relevant experience in customer support, quality assurance, or auditing.
- Preferred experience of six months to one year in insurance, damage assessment, or estimating.
- Basic knowledge of loss estimating, residential and commercial property, mitigation, and/or construction is advantageous.
- Ability to utilize technology for reviewing and analyzing written information and damage estimates is preferred.
- Background in IICRC, Water Restoration Technician (WRT), and Applied Structural Drying (ASD) certification is beneficial (or the ability to obtain within the first year of employment).
- Meticulous attention to detail is essential.
- Self-driven critical thinker capable of independent problem-solving.
- Ability to manage multiple tasks and adapt to shifting priorities.
- Strong written and verbal communication skills are necessary.
- Comfortable using communication tools such as Slack and MS Teams, including screen sharing and video conferencing.
- Familiarity with Xactimate/Xactware or similar estimating software is preferred.
- Strong interpersonal skills and the ability to collaborate effectively with others.
- Excellent time management skills, particularly in a metrics-driven environment.
- Ability to remain seated while working on a computer and using a phone for extended periods.
- High School Diploma or GED is required.
- Must reside in the states of Tennessee or Kentucky for payroll purposes.
About SERVPRO
For over five decades, SERVPRO has established itself as a leading provider of fire and water cleanup and restoration services, mold remediation, construction, and biohazard cleanup across the United States and Canada. Our network of over 2,200 independently owned and operated franchises is supported by a dedicated headquarters team. We are committed to fostering a professional community that values diversity, collaboration, and the unique contributions of each member.
SERVPRO is an equal opportunity employer. All applicants will be considered for employment without regard to age, race, color, religion, gender, sexual orientation, national origin, veteran, or disability status.