Join our team!
Assist Quality Assurance team with file audits, oversight of DOI complaint logs and company audits and other miscellaneous projects. Define and maintains Best Practices, refining them as new case law, regulations or innovate approaches come to light.
Essential Duties and Responsibilities:
- File Audits – utilize auditing software, SCORE, to provide basis of technical scores in performance evaluations and identify weaknesses to target areas for training.
- Assist reinsurers, state and primary carriers, MGAs with coordination of external/internal audits. Assist in collecting information needed for our clients undergoing an audit.
- Attend wrap-up meetings to help identify both individuals and issues for training or educational responses.
- Assist with coordination of SSAE 16 compliance audits.
- Assist with DOI complaint handling and logs, review claim file, work with handling unit manager and director, draft proposed response and communicate with the client for approval. Ensure timely and proper responses filed, ensure corrective action is taken, if required.
- Set-up and maintenance of external user log-in credentials and provide demonstrations on company claim systems to clients.
- Assist with maintenance of claims system data, with changes to template letters, external user log-in credentials maintenance/updates, auto assignment rules, and changes due to client program, location, and duplicate claims.
- Define and maintain Best Practices.
- Miscellaneous assigned duties and projects as issued by management
Education / Licensing:
- High School Diploma or higher with 5+ years claim handling experience.
- Supervisory experience preferred.
- Must possess a current Florida Adjusters license and required jurisdictional licensing.
- Must have a high level of interpersonal skills to handle sensitive and confidential situations and information.
- Previous negotiation and litigation skills preferred, but not necessary.
- Must be able to work independently and possess excellent written and verbal communication skills.
- Advanced knowledge of a variety of computer software applications in word processing, spreadsheets, database and presentation software. (Microsoft Office platform.)
- Requires long periods of sitting
- Requires working indoors in environmentally controlled conditions
- Requires lifting of files and boxes up to approximately 20 pounds
- Repeated use of keyboard, mouse and exposure to computer screen
If interested, please send resume to email@example.com.