Claims Quality Specialist
Job Summary
Evaluating claim files and ensuring adherence to quality standards, the fully remote Claims Quality Specialist will conduct audits, analyze trends, and provide coaching to claims professionals while supporting continuous improvement initiatives.
Key responsibilities
- Conduct quality reviews and audits of claim files to ensure compliance with client expectations and regulatory requirements
- Analyze audit results to identify trends and opportunities for improvement across claims operations
- Prepare quality reports and collaborate with leadership to drive operational excellence and training initiatives
Required qualifications
- High School Diploma
- Minimum of 5 years of related claims experience
- Minimum of 2 years of quality assurance, technical review, or supervisory experience preferred
- Strong understanding of claims best practices and compliance standards
- Computer experience with related claims and business software
Complete Job Description
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