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Claims, Quality Assurance Specialist - Worker's Compensation

Claims, Quality Assurance Specialist - Worker's Compensation

AIGAtlanta, GA, US
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Claims, Quality Assurance Specialist - Worker's Compensation

Join us as a Claims QA Specialist to make more of your specialist expertise and experience.

Our Claims teams are the proven problem solvers of choice for clients, delivering consistent technical excellence and showcasing our service differentiation to create an unparalleled global claims handling experience. Through a robust stakeholder feedback loop and supported by consistent processes and leadership, we take pride in delivering responsive, fair and professional service with empathy and efficiency.

How you will create an impact :

  • Complete quality reviews on all files within program guidelines while achieving and maintaining calibrated application of Line of Business best practices and claim handling expectations.
  • Organize and execute Benchmark reviews as a Team Lead, including risk assessment, scheduling, sampling, GQA review team oversight, results analysis, stakeholder feedback, addressing queries and reporting of results.
  • Establish and maintain effective communication with Line of Business partners including presentation of constructive feedback in a positive way.
  • Identification of trends and improvement opportunities with follow-up to ensure implementation of meaningful continuous improvement and / or action plan in partnership with claims.
  • Carry out second-line reviews and provide constructive feedback and training where required to drive calibration with our claims partners.
  • Commitment to personal development and skill enhancement.

What you'll need to succeed :

  • Proven claims experience handling and auditing Workers Compensation claims. Similar experience in other lines of business is desirable.
  • Excellent awareness of industry practices surrounding Claims Handling together with strong technical knowledge of subject matter and ability to apply it to the role.
  • Knowledge of key regulatory and legal requirements relevant to Workers Compensation claims.
  • Experience in claims analysis, Management Information and stakeholder reporting desirable.
  • Ability to make recommendations on action and improvement plans.
  • Excellent attention to detail.
  • Excellent verbal and written Communication skills, ability to influence and to manage stakeholder expectations.
  • Excellent written output skills with ability to create consistently factual, correct, high quality audit reports and supporting documentation.
  • Ability to address queries, disputes, challenges through the claims audit cycle while maintaining the philosophies of the GQA function.
  • Excellent organizational skills.
  • The role will require to work from other AIG offices (up to 25% travel).
  • Ready to accelerate your career? We would love to hear from you.

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