The Claims & Recovery Quality Assurance Manager develops, monitors, reports on, and seeks to improve quality standards and results for the Claims, Recovery, and Remediation products. By partnering with the applicable operations departments, the manager leads efforts to ensure company, carrier, state, and client expectations and standards are consistently being met and improved upon.

• Job Duties and Responsibilities:

Establish Quality Standards (15%)

• Continually assesses and understands client servicing and industry standards, commitments to carriers and clients, and state regulatory requirements
• Leads a team that ensures quality and productivity standards are established within the applicable operations areas and are reflective of our service commitments
• Leads efforts to gain alignment and understanding by employees and stakeholders as to what the quality standards are and why they’re important to our service delivery

Monitoring Performance Against Quality Standards (40%)

• Leads a team that creates and manages audit requirements and forms that align with quality standards and procedures
• Creates and manages the process for performing quality audits on operational processes and employees
• Collaborates with operations business areas to identify opportunities for improving quality results and supports those business areas in that improvement
• Provides resources as needed to support system enhancements including documentation of procedures, user acceptance testing, and production testing.

Audit Analysis and Calibration (25%)

• Ensures consistent and timely distribution of audits results to operations employees and / or operations leadership coaching, training, procedure changes, or system changes
• Aggregates and analyzes audit data to identify trends in individual employee performance, error types, and root cause
• Leads calibration efforts with operations leadership to assess trends and determine action items to improve the quality results
• Manages processes and people to ensure that agreed upon action items are implemented by the operations areas
• Communicates to the Operational Risk & Controls area any high-risk findings from audit efforts
• Recommends to the Business Solutions area opportunities for process improvement initiatives

Procedure Management (10%)

• Leads a team who manages the development and maintenance of operations procedure manuals
• Ensures that change control processes for updating procedures are in place and followed by operations areas
• As needed, provides support to the operations areas on educating employees around procedures including the sending of procedure reminders
• Collaborates with training staff and operations to ensure job aids and other training content are in alignment with procedures

Third Party Audit Support (10%)

• Assists in collecting requested documentation and information in response to third party audit requests from financial institutions, departments of insurance, and carriers
• Performs audits in response to third party audit requests
• Assesses audit results in collaboration with the third party and applicable operations leadership and recommends to operations areas actionable takeaways
• Qualifications (Education, Experience, Certifications & KSA):
• Bachelors degree required; or equivalent combination of education and experience
• Must be a licensed claims adjuster and maintain that license in all states that require it
• 5 – 7 years related experience
• 3 – 4 years leadership experience

The above statements are intended to describe the general nature and level of work being performed by people assigned to this job. They are not intended to be an exhaustive list of all responsibilities, skills, efforts or working conditions associated with a job.

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Please refer the Job description for details