Quality Assurance Specialist - Client Performance Analyst
PMA Companies

Charlotte, North Carolina

Posted in Insurance
15 days ago


Job Info


As an integral member of the Claims team for our Third Party Administrator, you will ensure the overall quality of workers' compensation claims handling in the assigned states and will provide technical guidance and expertise to analyze and direct major losses to a cost effective resolution.

Responsibilities:

  • Provide claims performance or quality/audit reviews.
  • Measure performance opportunities through use of file/reinspection process, calibration process, and/or audit processes.
  • Develop and implementing action plans focused on improving identified deficiencies and sharing best practices
  • Interact with various levels of claims management to communicate audit findings and recommend solutions to continuous process improvement.
  • Provide coaching and direction to field claims staff; assessing individual and group training needs and facilitate training programs
  • Communicate and train staff on case law and legislative changes that impact claims handling.
  • Demonstrate commitment to Company's Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards and laws applicable to job responsibilities in the performance of work.


Requirements:
  • 5+ years of workers' compensation claims handling experience; multiple jurisdictional expertise preferred.
  • MN experience required, GA and MA experience preferred.
  • Extensive knowledge of WC claims law is required;
  • Excellent verbal and written communication skills will be needed;
  • Demonstrated leadership, coaching and teamwork skills are essential;
  • Previous supervisor/management experience is strongly preferred;
  • Bachelor's Degree or equivalent experience is required; professional designations (CPCU, AIC, etc.) are a plus.



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