Claim Quality Review Sr Consultant

Posted 15 Days Ago
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Wyomissing, PA
Hybrid
71K-133K Annually
1-3 Years Experience
Cloud • Insurance • Professional Services • Analytics • Cybersecurity
The Role
Responsible for reviewing and evaluating claim files to ensure quality claim outcomes, analyzing results to identify best practices, and staying informed on industry trends. Requires strong technical knowledge in the insurance industry, project management skills, and excellent communication abilities.
Summary Generated by Built In

You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential.
Technical expert for assigned line(s) of business. Reports to Claim Quality Review Director. Responsible for reviewing and evaluating claim files for the assigned line(s) of business to determine whether the desired behaviors that result in quality claim outcomes are present. Collaborates on analysis of completed reviews with Claim Quality Review Director to identify best practice and opportunity areas. Calibrates with line of business managers to ensure consistency of quality reviews. Role may include those on a 12 - 24 month rotational assignment, offering a development opportunity for Claims Professionals to gain clear insight on quality and behaviors that impact results.
JOB DESCRIPTION:
Essential Duties & Responsibilities
Performs a combination of duties in accordance with departmental guidelines:

  • Completes technical file reviews for assigned line of business; gathers and interprets data, evaluating both technical and operational behaviors associated with functional roles.
  • Works with the Claim Quality Review Director to aggregate and analyze results from quality and manager reviews to identify trending of best practice and opportunity areas for assigned line of business and across the Claims organization.
  • Periodically serves as support for the Claim Quality Review Director in the assigned line of business.
  • Participates in Compliance or other function related reviews, as necessary.
  • Stays current on industry trends and developments.


May perform additional duties as assigned.
Reporting Relationship
Typically Director or above
Skills, Knowledge & Abilities

  • A solid understanding of the insurance industry, its practices and operations. Technical knowledge in assigned line of business.
  • Advanced analytical and problem solving skills with ability to manage and prioritize multiple projects.
  • Strong project management skills.
  • Excellent communication, presentation and interpersonal skills with the ability to work effectively with internal business partners.
  • Ability to influence others in accepting ideas that will lead to increased business results.
  • Strong computer skills including Microsoft Office Suite and other business related software systems.


Education & Experience

  • Bachelor's degree or its equivalent. Applicable professional designations preferred.
  • Typically a minimum of eight years of related work experience in the insurance industry with strong line of business technical expertise.


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I n certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In District of Columbia , California, Colorado, Connecticut, Maryland , New York and Washington, the national base pay range for this job level is $71,000 to $133,000 annually.Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. CNA offers a comprehensive and competitive benefits package to help our employees - and their family members - achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA's benefits, please visit cnabenefits.com .
CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact [email protected] .

Top Skills

Microsoft Office Suite

What the Team is Saying

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The Company
HQ: Chicago, IL
7,000 Employees
Hybrid Workplace
Year Founded: 1897

What We Do

CNA is one of the largest U.S. commercial property and casualty insurance companies. Backed by more than 125 years of experience, CNA provides a broad range of standard and specialized insurance products and services for businesses and professionals in the U.S., Canada and Europe.

As a company of allies, we understand the importance of fostering an inclusive and supportive culture for all employees. Our eight Employee Resource Groups elevate the voices of underrepresented groups and champion critical DEI initiatives in the workplace and beyond. We strive to promote an environment of inclusion and continuously work to ensure all employees feel valued and respected.

Why Work With Us

CNA knows the importance of having the tools you need to expand your expertise and develop your career. With a variety of cross-discipline and cross-functional opportunities, CNA provides you with the tools and resources needed to customize your career path and understand what is needed to be effective in your role.

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CNA Offices

Hybrid Workspace

Employees engage in a combination of remote and on-site work.

Typical time on-site: Flexible
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HQChicago, IL
Located in the heart of the loop, CNA’s headquarters are at 151 N Franklin. With close proximity to both L and Metra stations.

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