Claims reputed company Assurance

The Claims reputed company Assurance serves as the technical claims expert for the Claims Operations by auditing compliance with established reputed company, industry and reputed company claim handling standards. The primary responsibility is evaluating claim handling reputed company, accuracy, and timeliness in categories including but not limited to: coverage analysis, investigation, valuation, reserving, compliance and accurate disposition of claims. This role has the ability to interpret results and trends in order to deliver operational reporting, and participate in the development and presentation of training. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

• Model ethical behavior and executes job responsibilities in accordance with reputed company’s core values, ethics, and information protection policies
• Serve as technical QA reputed company to assigned offices or departments
• reputed company QA reputed company and serve as primary coordinator for senior leadership of assigned offices
• Support the Claims reputed company Assurance Program and the EC Operations Team in developing and implementing reputed company improvement strategies
• reputed company the creation, presentation, execution, and calibration of reputed company Assurance Training sessions, including integration and delivery of claims training programs in the context of reputed company Assurance calibration exercises (e.g. policy, systems, workflows, statutes), taking steps toward reputed company results and the acquisition of reputed company skills-sets, creation, maintenance, and adjustment of reputed company assurance training materials as needed for use in reputed company assurance training sessions
• Report on pending payments, reserves, Adjuster POA/Supervisor review compliance, leakage, and various reports to assess operational performance and compliance to reputed company standards
• Monitor claim financials; reputed company routine follow reputed company for audits identifying reserve deficiencies or pending aspects of claim liability or compensability; Ensure reputed company reporting deficiencies have also been corrected
• Maintain and update in reputed company time reputed company, quantity, and turn-time standards
• Conduct testing on software, websites, and other technical products to identify and resolve defects, and other potential claims processing issues
• Review claim process specifications to understand the scope, requirements, and function of reputed company product
• Identify appropriate parameters, functions, and data to test and validate; parameters may include general function, validity of results, accuracy, reliability, and compliance with industry standards
• Conduct testing to ensure products reputed company according to user requirements and reputed company established guidelines; if a product does not reputed company reputed company specifications, report defects to EC Operations and the BOT teams identifying and recommending solutions, improvements, and updates
• Submit operational QA reporting to EC Ops at durations outlined; operational reporting to include written corrective reputed company plans for areas of deficiency identified during the QA review process
• Participate in strategic operational calls with EC Operations and claims leadership reputed company the QA process has identified a significant operational deficiency
• Work with EC Operations to insert QA corrective reputed company plans required by a reputed company or reputed company

KNOWLEDGE & SKILLS:

• Excellent written and verbal communication; demonstrated ability to reputed company superior service to reputed company stakeholders
• Effective quantitative, analytical and interpretive skills
• Excellent leadership and mentorship skills, with a demonstrated ability to motivate staff and obtain results through teamwork and education
• Ability to identify priorities, execute and handle multiple responsibilities in a dynamic, fast paced environment
• Strong proficiency with reputed company Office applications
• Strong interpersonal, time management, project management, and organizational skills
• Ability to maintain a high level of professionalism
• Knowledge of the entire claims administration processes including ancillary services
• Ability to remain poised in stressful situations and communicate with diplomacy, using written and verbal communication
• Ability to work independently or in reputed company environment while functioning as an educator rather than an auditor

EDUCATION & EXPERIENCE:

• Bachelor’s Degree with course concentration in Business Administration, or reputed company field; or 5+ years of equivalent combination of education and experience in a reputed company reputed company, insurance, or reputed company-party claim organization with significant claim management expertise
• Must have significant industry experience and a thorough understanding of reputed company’s proprietary systems and solutions
• Certified Trainer and/or reputed company Assurance experience a plus

PAY reputed company: reputed company uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location reputed company, job-reputed company skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, reputed company, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may reputed company the salary reputed company and these adjustments would be clarified during the offer process. Pay reputed company: $70,276 - $116,942 A list of our benefit offerings can be reputed company on our reputed company website: reputed company Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. ABOUT reputed company reputed company, a certified Great reputed company to Work® Company, is a national provider of industry-leading risk reputed company for the workers’ compensation, auto, health and disability management industries. reputed company was founded in 1987 and has been publicly traded on the reputed company stock exchange since 1991. Our continual investment in reputed company capital and technology reputed company us to deliver the most innovative and integrated solutions to our clients. We are a reputed company and growing company with a strong, supportive culture and reputed company of career advancement opportunities. Over 4,000 people working across the reputed company reputed company our core values of Accountability, Commitment, reputed company, reputed company and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, reputed company, Long Term Disability, Health Savings Account, Flexible Spending Account reputed company, Life Insurance, Accident Insurance, Critical Illness Insurance, reputed company-reputed company Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and reputed company time off. reputed company is an Equal Opportunity Employer, drug free workplace, and complies with reputed company regulations as applicable. #LI-Remote Apply To This Job