Claims & Recovery Quality Assurance Analyst

This position will create and perform Quality Assurance Audits on Allied’s claims and recovery processes to assess and improve accuracy and compliance with state regulations, carrier policy interpretations, and client service standards. This position is responsible for creating, facilitating, and maintaining written procedures as well as perform system, procedure, and process testing to identify and implement process and quality improvements.

*Job Duties and Responsibilities:

Perform Quality Assurance Audits (50%)

• Perform Quality Assurance audits related to claim setup, adjudication, and settlement processes to ensure compliance with established procedures, state regulations, and carrier commitments

Identify Trending Errors (20%)

• Identify and collect error patterns and gaps in procedures and processes related to claim setup, adjudication, and settlement. Create and implement solutions while collaborating with the business units.

Calibrate Procedure and Process Manuals (10%)

• Validate, write, and format current and new procedure and process manuals to ensure they are consistent, well written, support system functionality and drive productive and compliant results.

Assisting in Direction and Testing (20%)

• Provide analytical responses and direction to claims and recovery employees for claim handling procedures and processes. Identify and create tips and alerts. (5%)
• Conduct research in response to carrier or other third-party examinations. (5%)
• Assist in regression testing for process and system enhancements. (5%)
• Other responsibilities and duties as needed. (5%)

*Qualifications (Education, Experience, Certifications & KSA):

• High School Diploma or GED required
• Bachelor’s degree preferred; or equivalent combination of education and experience
• Property & Casualty license (if auditing P&C claim processes)
• Maintains an adjuster license in all states that require it (if auditing P&C claim processes)
• 3 – 4 years related experience

The above statements are intended to describe the general nature and level of work being performed by people assigned to this job. They are not intended to be an exhaustive list of all responsibilities, skills, efforts or working conditions associated with a job.

#LI-AB2

#LI-Onsite

We offer our employees a robust compensation package! Our comprehensive benefits include: medical, dental and vision insurance coverage; 100% company-paid life and disability coverage, 401k options with company match, three weeks PTO by the end of the first year and much more. Allied proudly promotes from within as part of a strong commitment to providing career growth opportunities for employees of all levels. Our diverse business portfolio allows employees broad career options with the advantage of staying with the same organization.
All qualified candidates will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability status, protected veteran status, or any other characteristic protected by law.

To view our privacy statement click here

To view our terms and conditions click here