Quality Reviewer II

US-GA-Atlanta
3 weeks ago(11/22/2017 2:05 PM)
Requisition ID
2017-1442
Category
Claims
Business Unit
U.S. Services

Excellence In Everything We Touch

US Services Fld Ops

Position Summary

 

 

Reviews 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.

 

 

Responsibilities

 

  • Responsible for the review, testing and analysis of complex claim files to ensure quality work products are sent to clients.
  • Manages the tracking, reporting and analysis of quality data.  Makes decisions regarding the depth of testing required based various criteria including: adjuster, client, and previous/common errors.
  • Partners across departments and with other claims technical staff to ensure overall product quality.
  • Reviews and verifies information regarding complex claims to ensure the proper processing in accordance with established quality standards.
  • Reads and interprets complicated customer and vendor specifications.
  • Develops and assesses alternative methods to achieve uniform quality including identifying process variables and training opportunities.
  • Verifies corrected material and prepares quality assurance reports as appropriate.
  • Analyzes claims and process trends and makes corrective recommendations.
  • Continuously monitors performance and reports performance issues to appropriate management to coordinate the corrective action process.
  • Identifies best practices and applies these to meet efficiency and cost objectives and ensure measurements are applied to demonstrate results.
  • Assist in the training of other QA staff through formal classes when new processes are introduced to help ensure consistency throughout the department.
  • Upholds the Crawford Code of Conduct.

 

Requirements

 

  • Bachelors degree or equivalent combination of education and experience.

  • Five years of experience handling complex property and/or casualty claims.

  • Audit/quality control experience

  • Must have or secure and maintain the appropriate license(s) as required by the state(s) at the adjuster level.

  • Excellent writing and verbal communication skills

  • Strong analytical ability

  • Attention to detail.

  • Ability to work independently in a multi-tasking environment with a sense of urgency

  • Must possess critical thinking, interpersonal, problem solving, teamwork, and organizational skills.

Preferred:

  • Experience in automated testing of environment is strongly preferred

 

About Us

 

Based in Atlanta, Crawford & Company (NYSE: CRD-A and CRD-B) is the world’s largest publicly listed independent provider of claims management solutions to insurance companies and self-insured entities with an expansive global network serving clients in more than 70 countries. The Crawford Solution® offers comprehensive, integrated claims services, business process outsourcing and consulting services for major product lines including property and casualty claims management, workers compensation claims and medical management and legal settlement administration. More information is available at www.crawfordandcompany.com.

In addition to a competitive salary, Crawford offers you:

  • Career advancement potential locally, nationally and internationally. Crawford & Company has more than 700 locations in 70 countries;
  • On-going training opportunities through every stage of your career
  • Strong benefits package including matching 401k; health, dental, and life insurance; employee stock purchase plans; tuition reimbursement and so much more.

Crawford & Company participates in E-Verify and is an Equal Opportunity Employer. M/F/D/V

Crawford & Company is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford. No fee will be paid in the event the candidate is hired by Crawford as a result of the referral or through other means. 

 

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