Claims & Recovery Quality Assurance Analyst

Create and perform Quality Assurance audits on claims and recovery processes
Assess and improve accuracy and compliance with state regulations, carrier policy interpretations, and client service standards
Create, facilitate, and maintain written procedures
Perform system, procedure, and process testing to identify and implement process and quality improvements
Audit claim setup, adjudication, and settlement processes
Identify error patterns and process or procedure gaps
Create and implement solutions in collaboration with business units
Validate, write, and format procedure and process manuals
Provide analytical responses and direction to claims and recovery employees
Identify and create tips and alerts
Conduct research for carrier or third-party examinations
Assist in regression testing for process and system enhancements
Perform other responsibilities and duties as needed

• High School Diploma or GED required
• Bachelor’s degree preferred
• Equivalent combination of education and experience accepted
• Property & Casualty license if auditing P&C claim processes
• Adjuster license in all states that require it if auditing P&C claim processes
• 3–4 years of related experience

Demonstrates expertise in Quality Assurance audits, compliance assessment, and process improvement within claims and recovery operations. Proficient in creating and maintaining procedural documentation while collaborating with business units to implement effective solutions.

• Quality Assurance Audits
• Process Improvement
• Compliance Assessment
• Property & Casualty License
• Claims Adjudication

• Quality Assurance
• Process Testing
• Claims Auditing
• Analytical Responses
• Error Pattern Identification
• Procedure Documentation
• System Enhancements
• Regulatory Compliance
• Claims Recovery
• Research Conducting

• Collaboration
• Communication
• Problem Solving
• Attention to Detail
• Analytical Thinking

• High School Diploma
• GED
• Bachelor’s Degree (Preferred)
• Adjuster License

• Claims Processes
• Recovery Processes
• State Regulations
• Carrier Policy
• Client Service Standards