Quality Reviewer

Reviews low severity 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.

• Bachelor's degree or an equivalent combination of education and experience.
• Three years experience handling property and/or casualty claims with at least one year of audit/quality control experience.
• Excellent writing and verbal communication skills.
• Strong analytical ability.
• Attention to detail.
• Must possess critical thinking, interpersonal, problem solving, teamwork, and organizational skills.
• Demonstrates excellent work ethic and focus on work, tasks, priorities and improving the QA process.
• 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.

• Conducts thorough and accurate testing of claims before submission to clients. Claims are primarily focused on personal lines and large national accounts with some limited commercial assignments.
• Reviews and verifies claims information to ensure the proper processing in accordance with established quality standards.
• Reads and interprets customer and vendor specifications, reviews transactions, and compares to source documents to resolve errors and provide proper feedback.
• Verifies corrected material and prepares quality assurance reports as appropriate.
• Analyzes claims and process trends and makes corrective recommendations.
• Assists in the identification of new procedures, methods and/or tools to improve the efficiency of the quality process.
• Provides analysis and consulting support for the development and support of adjusters in the field; provides detailed feedback to service centers regarding trends and anomalies in the claim files.
• Continuously monitors process performance and reports performance to responsible management.
• Remains up-to-date with QA industry standards, principles and practices.
• Engages in continuing education and development of skills.
• Upholds the Crawford Code of Conduct.