财产索赔质量保证主管
Property Claims Quality Assurance Supervisor
开发工程职能支持限定地区（需当地身份）
公司California FAIR Plan Association
薪资$115,000 - $125,000/年
工作地点United States
地域资格限定地区（需当地身份）
时区要求日间重叠约 9 小时，基本正常作息
用工类型Full Time
发布时间昨天
数据来源Himalayas
注意地域限制：该职位明确限定在 United States 招聘。如果你是位于中国大陆的求职者，通常需要当地工作身份才能投递，或需与雇主确认是否接受独立合同（Contractor）形式合作。
职位概述
理赔质量保证主管领导质量保证代表或理赔质量与追偿分析师团队。该职位负责审查理赔文件的准确性及合规性，符合加利福尼亚州保险部（CDI）公平理赔结算实务法规。该职位还将管理与保险部的沟通，并协助理赔检查员进行承保分析。
主要职责与任务
- 与理赔质量与追偿分析师及QA代表团队协作，确保质量保证部门的日常工作的顺利进行。
- 制定并实施质量保证政策、流程和工作流，以促进一致性、效率和高质量服务的交付。
- 招聘、培训、指导和支持质量保证代表及理赔质量与追偿分析师。
- 提供文件数据用于文件审查，并维护审计平台。
- 指导和监督文件审查，并处理提交给CDI的投诉。
- 向团队成员提供关于审计准确性和CDI回复信件的反馈。
- 提供反馈和审查结果，提出培训和改进的建议。
- 管理每月文件审计校准，并提供结果总结以确保一致性。
- 审查、分析并就理赔处理实践提出建议。
- 审查维修估价的准确性及是否符合行业/CFP指南和客户要求。
- 汇总估价修订请求，并与网络承包商协调获取估价修正。
- 创建并维护工作簿、问卷、流程和培训材料，以提高准确性和一致性。
- 领导各种项目，包括但不限于QA软件和报告的实施。
教育与经验
- 本科或同等学历优先。
- 精通质量保证和财产理赔。
- 至少5-10年财产保险理赔经验，2年以上管理经验。
- 强大的组织、文件管理和时间管理能力。
- 注重细节；能够优先排序并做出重要决策。
- 出色的书面和口头沟通能力。
- 适应性强，具备管理变化的实际能力。
- 需要使用MS-Office。
- 精通Xactimate估价程序。
- 持有CEA认证和CA公平理赔结算实务认证。
查看英文原文
POSITION SUMMARY
The Claims Quality Assurance Supervisor leads a team of Quality Assurance Representatives or Claims Quality & Subrogation Analysts. This role is responsible for reviewing claim files for accuracy, and compliance, with the CA Department of Insurance (CDI) Fair Claims Settlement Practices Regulations. This role will also manage communications with the Department of Insurance and assist claims examiners with coverage analysis.
PRINCIPAL DUTIES & RESPONSIBILITIES
- Collaborate with Claims Quality & Subrogation Analysts and QA Representative teams to maintain the daily workflow across the Quality Assurance Department.
- Develop and implement quality assurance policies, procedures, and workflows that promote consistency, efficiency, and delivery of high-quality service.
- Hire, train, mentor, and support Quality Assurance Representatives and Claims Quality & Subrogation Analysts
- Provide file data for file reviews and maintain the audit platform.
- Direct and oversee file reviews and manage responses to complaints filed with CDI.
- Provide feedback to team members regarding auditing accuracy and CDI response letters.
- Provide feedback and results/ on findings and make recommendations for training and improvement.
- Manage monthly file audit calibrations and provide summary of the results to ensure consistency
- Review, analyze, and provide suggestions for claim handling practices
- Review repair estimates for accuracy and adherence to industry/CFP guidelines, and client requirements.
- Compile estimate revision requests and coordinate with network contractors to obtain estimate corrections.
- Create and maintain workbooks, questionnaires, processes, and training materials to promote accuracy and consistency.
- Lead various projects, including but not limited to QA software and report implementation.
EDUCATION & EXPERIENCE
- Bachelor’s degree or equivalent preferred.
- Strong knowledge of quality assurance and property claims.
- Minimum of 5-10 years property insurance claims experience, 2+ years of supervisory experience.
- Strong organizational, file management, and time management skills.
- Attention to detail; ability to prioritize and make strong decisions.
- Excellent written and oral communication skills.
- Adaptability and demonstrated ability to manage change.
- Working experience with MS-Office is required.
- Proficient in the Xactimate estimating program.
- Certified in CEA and CA Fair Claims Settlement Practices Regulations.
Salary: $115,000-$125,000Originally posted on Himalayas
本页面信息整理自 Himalayas，版权归原发布方所有。职位可能随时关闭，投递请以原始页面为准。
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