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Senior Claims Quality Assurance Specialist
2 months ago
The VP Claims Quality Assurance Director is responsible for leading and developing claims handling standards and compliance, as well as providing oversight and direction on quality claims handling to field leadership. This position is a key stakeholder managing claim-level relationships with insurance carrier partners in compliance with contractual standards, including carrier reporting, audit management, and result coordination.
Key Responsibilities- Develop and implement claims handling standards and compliance procedures.
- Provide oversight and direction on quality claims handling to field leaders.
- Manage carrier relations and correspondence.
- Ensure claim quality audit scores, compliance, and action plans are met.
- Lead department employees to achieve performance goals.
- Deliver high-level customer service to clients.
- Set departmental objectives and establish policies and procedures.
- Work closely with department managers to identify opportunities for improvement.
- Conduct external and carrier audits as needed.
- Oversee Quality Claim Standard Implementation and Management.
- Internal claims oversight, training, and documentation.
- Provide strategic guidance on system and product enhancements.
- Oversee claim data corrections.
- Responsible for carrier Ad Hoc reporting.
- Participate in client and insurance carrier stewardships and capabilities presentations.
- Strong proficiency in Microsoft Office Suite.
- Excellent written and verbal communication skills.
- Sense of urgency and ability to multitask in a dynamic environment.
- Bachelor's degree required.
- 10 years prior progressive, related experience required, with 5+ in a related management capacity.
- Claims experience in workers' compensation, TX Nonsubscriber, USL&H, and liability. Property is a plus.
- Insurance carrier experience.
CorVel uses a market-based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions.
For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during the interview process taking into consideration experience, qualifications, and overall fit for the role.
Pay Range: $105,531 – $164,037
