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Ryze Claim Solutions

National claims services outsourcing for insurers

QA Specialist

Claims AdjudicationPosted on Nov 12
Full-timeRemote in USANo salary listedRemote

About the Job

Requirements

  • Strong quality judgment on residential property claims.
  • Working knowledge of carrier guidelines and account requirements.
  • Estimating skill in Xactimate or the carrier's preferred system, and an active adjuster license.
  • Ability to audit work product and give quality feedback to independent reviewers.
  • Ability to use data to judge quality and time in process.
  • Interest in how rules and systems drive automation.
  • Availability during core business hours and peak periods to answer reviewer questions and client escalations while files are moving.

Responsibilities

  • Source and vet independent (1099) reviewers, working with leadership and recruiting, including confirming licensing and qualifications.
  • Create and maintain onboarding materials on carrier guidelines, account requirements, and quality standards for independent reviewers.
  • Answer independent reviewer questions on carrier guidelines and account requirements so files keep moving.
  • Audit completed 1099 work product against quality standards, give feedback on deliverables, and use quality and turnaround data to decide how files are assigned, including offering more files or ending an engagement.
  • Offer and assign files across the independent reviewer network so carrier deadlines are met, including in busy periods.
  • Define the rules QAi checks on each claim, working with IT, who build and configure the tool.
  • Serve as the knowledge expert for assigned accounts, including carrier guidelines, authority limits, and preferred systems.
  • Act as the client escalation point for files, taking the load off field leaders and account executives.
  • Update the estimate based on carrier rules and photos provided, using the license in that state and the carrier's preferred system, such as Xactimate.
  • Complete reviews after the leading work is done; review during slow periods or on tight timelines, but not during busy periods.
  • Track process and time to complete tasks; manage quality and cycle time, not cost.

About the Company

Ryze Claim Solutions

National claims services outsourcing for insurers

Ryze Claim Solutions is a claims services firm with national coverage that provides value-added outsourcing for insurers and self-insured entities. It manages claims on behalf of clients, handling the end-to-end process and delivering high levels of service to protect client reputations and outcomes. The company works by combining a nationwide footprint with dedicated claim-handling capabilities, supporting insured and self-insured risks through outsourced claims management, loss handling, and related services. What sets Ryze apart from competitors is its emphasis on client reputation, people, and results, offering a scalable outsourcing model and a strong service orientation that aims to improve claims outcomes and client peace of mind. The goal is to help clients control costs, improve efficiency, and achieve favorable claim results by delivering reliable, responsive, and value-driven claims management.

Company size
201-500
Company stage
Not listed
Total funding
Not listed
Headquarters
Tampa, FL
Founded
Not listed

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