Quality Assurance Senior Claim Auditor - Financial Lines

Chubb Jersey City , NJ 07097

Posted 3 weeks ago

Position Overview:

As a member of the Claims Quality Assurance and Compliance Team, a person in this position is responsible for supporting continuous improvement by measuring compliance with best practices in quality audits. Responsibilities also include partnering with various levels of internal and external claims management to analyze and communicate findings, recommend solutions and work collaboratively in the development of meaningful action plans. This position reports to a Quality Assurance and Compliance Team Manager, AVP.

Roles and Responsibilities:

  • Conduct Claim Technical Quality Audits of:
  • CHUBB Claims Practice Disciplines/Segments/Offices.

Other disciplines within Casualty Lines:

  • Third Party Administrators

  • Self-Administered Programs

  • Assist in the sharing and distribution of Best Practice review results through written reports and presentations.

  • Facilitate the calibration process for claim managers that perform Self Reviews.

  • Perform a thorough analysis of quality review results and translate results into key opportunity areas.

  • Collaborate with claim management in the development of meaningful action plans that detail the tasks, resources, and timeframes necessary to improve claim handling.

  • Facilitate, support, and measure the execution of action plans.

  • Assist in the development and enhancement of CHUBB's Best Practice Guidelines.

  • Lead quality reviews including pre-work such as file selection and communication, assuring the review process is proper and timely, and reporting at the conclusion of the review.

  • Lead or actively participate in training claim handlers on technical claims content.

  • Provide training to managers in the use of the quality review tool for results and analysis.

  • Interact with multiple business partners (Underwriting, Claims, Internal Audit, TPAs, Accounts, Global Legal & Compliance), as required.

  • Contribute to the team, share ideas, create corrective actions, and identify root causes across claims units.

  • Stay current within respective field(s) of expertise, jurisdictional changes and relative licensing.

  • Up to 10% travel.

Skills and Experience:

  • Knowledge of Insurance Industry and Claims Handling (TPA and Carrier perspective)

  • Financial Lines: Deep technical knowledge of the Financial Lines of business. An additional line of business - Casualty - is also preferred.

  • Thorough knowledge of CHUBB products, services, and coverages along with a good understanding of applicable legal principles.

  • Excellent interpersonal, written and verbal communication and problem resolution skills

  • Proficient information systems understanding and skills, to include Microsoft Office programs (Word, Excel, Access, and Power Point) and the internet.

  • Ability to collect, dissect, and analyze complex data sets to identify root causes/trends, leakage and quantify the cost of non-compliance.

  • Ability to provide consultation and expert technical claim advice to management.

  • Ability to excel independently and in a team environment.

  • Excellent time management and organizational skills.

  • Strong background in Insurance Operations also preferred.

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Quality Assurance Senior Claim Auditor - Financial Lines

Chubb