Claims Quality Audit Analyst

Posted 5 Days Ago
Be an Early Applicant
Morristown, NJ, USA
In-Office
69K-107K Annually
Mid level
Industrial
The Role
The Claims Quality Audit Analyst oversees quality reviews, manages claim compliance, partners with leadership to implement action plans, and supports training initiatives to enhance claims handling accuracy.
Summary Generated by Built In

At Coaction, we’re a unique mix of leaders, achievers, thinkers, and team players with a high-performance mindset and a diverse skillset. We bring our industry expertise together to continually push the boundaries of what insurance can be for our clients.

The Claim Quality Audit Analyst, is responsible for overseeing claim quality reviews, calibration of manager reviews, compliance monitoring, and training initiatives to ensure consistent, accurate, and high‑quality claim handling across all claim business units. The Claims Analyst partners closely with claim leadership to identify gaps, implement action plans, and drive continuous improvement.

Key Responsibilities:

Quality Review  

  • Working with the AVP of the Claim Excellence team, lead, manage, and coordinate all claim quality, focused and targeted reviews across units.

  • Ensure the enhanced claim review questionnaire is used consistently, including root‑cause analysis and leakage evaluation and claim handling aligns with company protocols.

  • Oversee quality control and action plans of claim review outputs.

  • Produce results and trend reports for leadership review.

Calibration & Consistency

  • Facilitate claim management calibration reviews and maintain calibration scoring.

  • Ensure consistent application of standards across all claim lines.

  • Partner with leadership to maintain alignment.

Action Planning & Performance

  • Translate claim department claim review results into actionable improvement plans.

  • Track and validate action‑plan outcomes tied to performance goals.

  • Monitor progress across all claim units and escalate risks.

Training & Development Integration

  • Partner with learning and development teams to design and deliver curriculum based on claim review findings.

  • Support coaching, training and skill‑building for claim examiners and leaders.

  • Maintain feedback loops to evaluate training effectiveness.

Compliance Oversight

  • Ensure claims meet internal claim handling protocols and regulatory requirements.

  • Maintain documentation, testing, and claim review trails for compliance reviews.

  • Support preparation for regulatory exams and market conduct reviews.

Leadership & Collaboration

  • Provide day‑to‑day direction to claim departments

  • Serve as subject‑matter expert for quality, compliance, and training integration.

  • Support strategic objectives as defined by the AVP of Claim Excellence.

Qualifications

  • 4+ years of claim leadership experience in property/casualty or professional liability.

  • Deep technical knowledge of claims and claim regulatory compliance.

  • Experience in quality audit, claim training, or process improvement.

  • Strong analytical and communication skills.

  • Ability to lead cross‑functional initiatives and influence without authority.

Success Measures

  • Reduction in claim leakage and improved accuracy of claim handling.

  • Consistent audit completion and calibration scores across units.

  • Measurable improvements in claim examiner/supervisor capability.

  • Stronger compliance readiness and fewer regulatory findings.

  • Timely execution and completion of action plans.

**This is not a fully remote position. Applicants must sit in our Morristown, NJ office on our hybrid work schedule.**

Salary range specific to for this role : $69,000-$107,000 + discretionary incentive bonus + benefits depends on various factors including, without limitation, individual and organizational performance. The offered rate of compensation will be based on individual education, experience, and qualifications.  In addition, employees are eligible for standard benefits package including paid time off, medical, dental and retirement.

Equal Opportunity Employer

Coaction is an Equal Employment Opportunity employer. Coaction’s policy is not to discriminate against any applicant or employee based on race, color, religion, national origin, gender, age, sexual orientation, gender identity or expression, marital status, mental or physical disability, and genetic information, or any other basis protected by applicable law. Coaction also prohibits harassment of applicants or employees based on any of these protected categories.

If your application is selected, you will receive an email directly from the Coaction Recruiting Team at [email protected] asking you to contact a member of the Coaction Recruiting Team. Any other method of contact may be fraudulent.

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The Company
Alpharetta, Georgia
447 Employees
Year Founded: 2009

What We Do

Coaction Global (Coaction) is an A.M. Best “A-“ (Excellent)-rated, property and casualty (P&C) insurance company. Founded in 2009 as ProSight Global, Coaction today is a specialty underwriter providing property, casualty, entertainment, executive liability, and multi-line coverages to U.S. customers via open brokerage and delegated underwriting authority platforms. Coaction’s authentic, results-oriented culture is reflected in the company’s focused approach to fulfilling individual customer needs by combining product, analytics, and underwriting capabilities with strong industry knowledge and partnerships. Through data-driven insights and collaboration, the company coacts with customers and partners to rationally manage risk for a more confident and sustainable future

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