Senior Quality Assurance Analyst

Overview

Aspire General Insurance Company and its affiliated general agent, Aspire General Insurance Services, are on a mission to deliver affordable specialty auto coverage to drivers without compromising outstanding service.

Under the direction of QC Management, the Sr. Quality Assurance Analyst serves as an integral role within the claims organization, helping to drive operational efficiencies and improve claim handling by providing insights regarding claim handling, compliance, and customer service. The Sr. Quality Assurance Analyst works collaboratively with members of the claims department and management across the organization while continuously supporting the improvement of the technical quality of the claims product while measuring compliance through the completion of quality reviews.

The Sr. Quality Assurance Analyst partners with various levels of claims management to analyze and communicate findings, recommend solutions, and assist in the development of meaningful action plans.

• Conduct quality audit file reviews.
• Participate in or lead various claim projects or targeted audits.
• Assist in the sharing and distribution of best practices through written reports, PowerPoint presentations, oral presentations, and various reporting platforms.
• Lead or facilitate the calibration process for claim managers and the audit team.
• Monitor, analyze and improve claims performance in all areas including loss control, LAE, customer satisfaction, associate engagement, and development.
• Actively participate in the development and implementation of any company customer satisfaction surveys or net promoter scores.
• Comply with state and federal laws, Department of Insurance criteria, insurance carrier criteria and follow and enforce Aspire General Insurance Company/partner’s policies, procedures and work rules.
• Perform a thorough analysis of quality review results and translate results into key opportunity areas.
• Assist in the development and maintenance of claim procedure manuals and training manuals.
• Work with all levels of claims staff to ensure that the claims department is functioning at its best level of performance.
• Identify the need for technical improvements in any system used by the claims department and work with I/T in the development of those system enhancements.
• Actively participate in enhancements and serve as an agent of change in the development and enhancement of Aspires’ best practice guidelines.
• Perform ad hoc auditing depending on the needs of the company.
• Assist in testing processes, procedures, systems, and reports.
• Actively participate in training claim handlers on technical claims content and analysis of audit findings.
• A strong contributor to the team, sharing ideas, corrective actions, or other QA collateral with the AQ team and across the claim organization.
• Stay current on compliance laws and insurance regulations in multiple jurisdictions.
• Interact with multiple business partners as required.
• Ensure ongoing adjudication of claims within company standards and industry best practices and regulations.
• Support Aspires’ ongoing digital and process enhancements, providing innovative solutions for utilizing data management.
• Produce grammatically correct and clearly written correspondence including letters, memos, reports and claim file documentation.

• Four plus years’ experience in Property and Casualty insurance industry (Non-Standard Preferred)
• Knowledge of Insurance industry and claims handling trends, compliance, and law
• Expertise in technical knowledge of Property and Casualty claim handling.
• Supervisor or management experience preferred.
• Thorough knowledge of Aspires’ best practice and claim processes.
• Excellent interpersonal, written, and verbal communication and problem resolution skills.
• Proficient information systems understanding and skills, to include Microsoft Office programs, and the internet.
• Ability to dissect QA data elements, identify root causes/trends, and quantify the “cost of non‑compliance”.
• Ability to provide consultation and expert advice to management.
• Ability to excel independently and in a team environment.
• Must be a self‑starter and…