Insurance Claims Quality Analyst

2 months ago


Jacksonville, Florida, United States Paul Davis Restoration, Inc. Full time
Job Overview

Are you looking to make a significant contribution to your community within a diverse and inclusive organization? At Paul Davis Restoration, Inc., we offer a dynamic and expanding environment that supports your personal and professional growth.


Position Summary:

Paul Davis Restoration, Inc. is a national franchise organization specializing in emergency services, restoration, and reconstruction for both residential and commercial properties affected by water, fire, mold, storms, and other disasters. With over 350 franchises across the US and Canada, we have assisted more than 2 million property owners in restoring their properties and lives since 1966. As part of the Quality Assurance team, the Quality Assurance Analyst plays a crucial role in ensuring compliance with carrier partner guidelines and industry standards.


Key Responsibilities:
  • Conduct precise and timely reviews of estimates and documentation using primary technology platforms such as XactAnalysis, Symbility, and CMS.
  • Ensure accuracy through internal reinspection processes.
  • Monitor timeliness via automated reporting of documented events.
  • Review estimates and documentation for various mitigation assignments, including water, mold, and emergency services.
  • Utilize knowledge of industry standards and carrier guidelines to ensure adherence to service level agreements.
  • Engage in direct communication with franchisees and insurance carriers to meet compliance requirements.
  • Provide coaching to franchises on enhancing their estimating and documentation performance.
  • Identify trends and communicate findings to management and consultants.
  • Assist franchises with estimating requirements and technical inquiries related to claim management platforms.

Required Skills and Qualifications:
  • Proficient in using laptops and Microsoft Office applications.
  • General understanding of the insurance industry, including mitigation and reconstruction concepts.
  • Strong communication skills, both verbal and written, with the ability to adapt based on context.
  • Ability to problem-solve independently and manage priorities effectively.
  • Familiarity with estimating platforms such as Xactware and Symbility.
  • High School Diploma or GED; Bachelor's Degree or equivalent experience in insurance claims is preferred.
  • Minimum of 1 year of experience in document review or a similar analytical role.

Work Environment:

This position is primarily office-based, with exposure to standard office conditions. Occasional travel may be required for franchise visits and training sessions.


Equal Opportunity Employer:

Paul Davis Restoration is committed to providing equal employment opportunities to all individuals, regardless of race, color, creed, religion, gender, age, sexual orientation, national origin, disability, veteran status, or any other characteristic protected by law.


Flexible work-from-home options are available.


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