State Licensed Claims QA Specialist

Job Summary

Working remotely in a full-time capacity, the State Licensed Claims QA Specialist will complete audits of claim files, assist in developing reporting and action plans, and analyze data trends to enhance claims handling quality.

Key responsibilities

• Completing audits of open and closed claim files to ensure compliance with claims handling guidelines
• Assisting in the development of after-audit reporting and action planning to address identified issues
• Coaching and training staff on new processes based on audit results and action plans

Required qualifications

• BA/BS degree and/or working towards CPCU, AIC, SCLA, or other relevant insurance designations
• 3+ years of experience specializing in claims, preferably with injury/casualty claims experience
• Individual Independent State Adjuster licenses are preferred, or the ability to obtain them within 60 days of hire
• Preferred background in claims quality assurance and auditing across multiple lines of business
• Strong knowledge of customer service principles and practices