Quality Reviewer

Responsibilities

• Conducts thorough and accurate testing of claims before submission to clients.
• Reviews and verifies claims information to ensure the proper processing in accordance with established quality standards.
• Reads and interprets customer and vendor specifications.
• Reviews transactions and compares to the source documents to resolve errors and provides proper feedback.
• Verifies corrected material and prepares quality assurance reports as appropriate.
• Analyzes claims and process trends and makes corrective recommendations.
• Affords assistance in identifying new procedures, methods, and/or tools to improve the efficiency of the quality process.
• Provides analysis and consulting support for the development and support of adjusters in the field.
• Provides detailed feedback to service centers regarding trends and anomalies in the claim files.
• Continuously monitors process performance and reports performance to responsible management.

Qualifications

• Bachelor's degree or an equivalent combination of education and experience.
• Three years experience handling property and/or casualty claims with at least one year of audit/quality control experience.
• Excellent writing and verbal communication skills.
• Strong analytical ability.
• Attention to detail.
• Must possess critical thinking, interpersonal, problem-solving, teamwork, and organizational skills.
• Must have or secure and maintain the appropriate license(s) as required by the state(s) at the adjuster level.
• Must complete continuing education requirements as outlined by Crawford Educational Services.