Casualty Claims Quality Assurance Consultant

About the role

This position is eligible to work from home anywhere in the US.

Responsibilities

• Conducts casualty-focused file reviews across Regional, Complex & Specialty teams
• Measures handling quality against EMC Best Practices, Casualty KPIs, and state requirements
• Performs targeted audits on specific casualty focus areas with stakeholders
• Establishes audit standards and procedures with Claims/Casualty leadership
• Documents findings, analyzes trends, and identifies improvement opportunities
• Prepares and delivers audit reports, summaries, and presentations
• Recommends process improvements and future audit focus areas
• Communicates results and action plans to stakeholders
• Supports implementation of new audit processes and continuous improvement efforts
• Provides insights to drive consistency, accountability, and better claim outcomes
• Conducts claims-wide audits with leadership and QA partners as needed
• Adapts audit scope based on evolving business needs and priorities
• Participates in training sessions and shares audit insights with teams
• Affords assistance with special projects, including guideline reviews and KPI-focused initiatives
• Collaborates cross-functionally to ensure audit and project goals are met

Requirements

• Bachelor’s degree, preferably in insurance, finance, accounting, business administration or related field or equivalent relevant experience
• Eight years of commercial lines casualty claim handling experience, including experience with litigated claims or related experience
• Prior audit experience preferred
• Insurance industry designations (e.g. INS, AIC, CPCU) preferred

Qualifications

• Excellent understanding of the casualty claims function
• Strong understanding of casualty claims handling procedures, principles, standards and best practices
• Strong knowledge of medical and legal terminology and legal aspects of court procedures affecting legal liability
• Strong ability to gather facts, analyze alternatives and recommend solutions
• Excellent organizational and analytical skills
• Excellent customer service and communication skills
• Strong computer skills, including Microsoft Office Suite
• Ability to manage multiple tasks and meet deadlines

Skills

• Excellent understanding of the casualty claims function
• Strong understanding of casualty claims handling procedures, principles, standards and best practices
• Strong knowledge of medical and legal terminology and legal aspects of court procedures affecting legal liability
• Strong ability to gather facts, analyze alternatives and recommend solutions
• Excellent organizational and analytical skills
• Excellent customer service and communication skills
• Strong computer skills, including Microsoft Office Suite

Benefits

The hiring salary range for this position will vary based on geographic location, falling within either of the following: $85,799 - $118,545 or $94,826 - $130,394

Pay

A hiring range represents a subset of the full salary range. The actual salary will depend on several factors, including relevant education, skills, and experience of an applicant, geographic location, and business needs.

Schedule

Flexible work schedule available.

Company Information

Our employment practices are in accordance with the laws that prohibit discrimination due to race, color, creed, sex, sexual orientation, gender identity, genetic information, religion, age, national origin or ancestry, physical or mental disability, medical condition, veteran status, active military status, citizenship status, marital status or any other consideration made unlawful by federal, state, or local laws. All of our locations are tobacco free including in company vehicles.