Quality Reviewer II (Finance)
Reviews property and/or casualty claims to ensure quality and compliance with client instructions and service level agreements. Investigates and analyzes quality trends, recommends solutions and ensures corrections are made.
- Bachelors degree or equivalent combination of education and experience.
- Five years of experience handling complex property and/or casualty claims and Xactimate experience.
- Audit/quality control experience
- Experience in automated testing of environment is strongly preferred
- Excellent writing and verbal communication skills
- Strong analytical ability
- Attention to detail.
- Ability to work independently in a multi-tasking environment with a sense of urgency
- Must possess critical thinking, interpersonal, problem solving, teamwork, and organizational skills.
- Must have or secure and maintain the appropriate license(s) as required by the state(s) at the adjuster level.
- Must complete continuing education requirements as outlined by Crawford Educational Services
- Responsible for the review, testing and analysis of complex claim files to ensure quality work products are sent to clients.
- Manages the tracking, reporting and analysis of quality data. Makes decisions regarding the depth of testing required based various criteria including: adjuster, client, and previous/common errors.
- Partners across departments and with other claims technical staff to ensure overall product quality.
- Reviews and verifies information regarding complex claims to ensure the proper processing in accordance with established quality standards.
- Reads and interprets complicated customer and vendor specifications.
- Develops and assesses alternative methods to achieve uniform quality including identifying process variables and training opportunities.
- Verifies corrected material and prepares quality assurance reports as appropriate.
- Analyzes claims and process trends and makes corrective recommendations.
- Continuously monitors performance and reports performance issues to appropriate management to coordinate the corrective action process.
- Identifies best practices and applies these to meet efficiency and cost objectives and ensure measurements are applied to demonstrate results.
- Assist in the training of other QA staff through formal classes when new processes are introduced to help ensure consistency throughout the department.
- Upholds the Crawford Code of Conduct.
