Claims Quality Assurance Supervisor

At EMC, you'll put your skills to good use as an important member of our team. You can count on gaining valuable experience while contributing to the company's success.

EMC strives to hire and retain the best people by engaging, developing and rewarding employees.

Location Preference : Ideal candidate will be located in Iowa.

Oversees and maintains the claims quality assurance (QA) program across all lines of business. Sets the standards and practices within the QA function, including the schedule and frequency of all audits, in coordination with management.

Actively leads meetings to discuss QA results, involving collaboration with QA team and claims teams. Drives efficiency within the QA team and actively conducts audits on an as needed basis.

Provides analysis to upper management on QA trends, improvement opportunities and training needs. Leads and develops QA team members, following through on performance management expectations.

Essential Functions :

Ensures QA team strategies are being followed within the team across all lines of business, including setting and maintaining QA expectations

Creates audit timelines based on team schedule. Schedules checkpoints with team as appropriate, keeping manager informed of progress and setbacks

Prepares audit summary reports and distributes to involved parties

Initiates each audit process of all claims teams across each line of business, including leading kick off and calibration meetings ensuring the process is collaborative, builds partnerships, and provides value

Ensures the QA team delivers consistent customer experiences and results, decreases cost, and increases efficiencies for all EMC claims teams based on audit findings

Solicits feedback and adjusts processes based on feedback received in coordination with management

Conducts collaborative claim evaluations file reviews and audits for claims teams

Measures the quality of file handling against EMC’s claims best practices

Collaborates with claims teams to plan and identify audit scope and parameters

Makes recommendations for improvements and future audits

Reviews claim files to evaluate compliance with regulatory requirements

Documents overall evaluation and audit findings and analyzes identified trends

Guides team through complex work issues and answers questions

Collaborates with team members to establish performance goals and monitors status

Interviews, hires, and recommends salary adjustments for team members

Resolves disciplinary issues, reviews results, action plans, and progress

Develops team expertise and assists with succession planning, including identifying talent and implementing development plans for critical positions

Performs critical analysis of QA results to identify trends and underlying causes of issues or knowledge gaps that could impact other claims teams

Develops a wide bank of KPI’s to be utilized across the audit spectrum measure results of audits

Communicates KPI information to QA team and claims teams to ensure transparency with goals and measures

Education & Experience :

Bachelor’s degree or equivalent relevant experience

Ten years claims adjusting experience, including at least four years of claims quality audit experience

Insurance designations preferred

Knowledge, Skills, & Abilities :

Superior knowledge of the theory and practice claims handling

Good knowledge of insurance contracts, coverage, practices, and procedures

Advanced analytical abilities and demonstrated experience of good judgment with respect to coverages and reserving

Excellent knowledge of the quality assurance function

Good leadership qualities with the ability to motivate and develop team members

Strong organizational and written and verbal communication skills