Claims Quality Assurance Supervisor

At EMC, you’ll put your skills to good use as an important member of our team. You can count on gaining valuable experience while contributing to the company’s success. EMC strives to hire and retain the best people by engaging, developing and rewarding employees.

Location Preference: Ideal candidate will be located in Iowa.

Oversees and maintains the claims quality assurance (QA) program across all lines of business. Sets the standards and practices within the QA function, including the schedule and frequency of all audits, in coordination with management. Actively leads meetings to discuss QA results, involving collaboration with QA team and claims teams.  Drives efficiency within the QA team and actively conducts audits on an as needed basis.  Provides analysis to upper management on QA trends, improvement opportunities and training needs.  Leads and develops QA team members, following through on performance management expectations.

Essential Functions:

• Ensures QA team strategies are being followed within the team across all lines of business, including setting and maintaining QA expectations

• Creates audit timelines based on team schedule.  Schedules checkpoints with team as appropriate, keeping manager informed of progress and setbacks

• Prepares audit summary reports and distributes to involved parties

• Initiates each audit process of all claims teams across each line of business, including leading kick off and calibration meetings ensuring the process is collaborative, builds partnerships, and provides value

• Ensures the QA team delivers consistent customer experiences and results, decreases cost, and increases efficiencies for all EMC claims teams based on audit findings

• Solicits feedback and adjusts processes based on feedback received in coordination with management

• Conducts collaborative claim evaluations file reviews and audits for claims teams

• Measures the quality of file handling against EMC’s claims best practices

• Collaborates with claims teams to plan and identify audit scope and parameters

• Makes recommendations for improvements and future audits

• Reviews claim files to evaluate compliance with regulatory requirements

• Documents overall evaluation and audit findings and analyzes identified trends

• Guides team through complex work issues and answers questions

• Collaborates with team members to establish performance goals and monitors status

• Interviews, hires, and recommends salary adjustments for team members

• Resolves disciplinary issues, reviews results, action plans, and progress

• Develops team expertise and assists with succession planning, including identifying talent and implementing development plans for critical positions

• Performs critical analysis of QA results to identify trends and underlying causes of issues or knowledge gaps that could impact other claims teams

• Develops a wide bank of KPI’s to be utilized across the audit spectrum measure results of audits

• Communicates KPI information to QA team and claims teams to ensure transparency with goals and measures

Education & Experience:

• Bachelor’s degree or equivalent relevant experience

• Ten years claims adjusting experience, including at least four years of claims quality audit experience

• Insurance designations preferred

Knowledge, Skills, & Abilities:

• Superior knowledge of the theory and practice claims handling

• Good knowledge of insurance contracts, coverage, practices, and procedures

• Advanced analytical abilities and demonstrated experience of good judgment with respect to coverages and reserving

• Excellent knowledge of the quality assurance function

• Good leadership qualities with the ability to motivate and develop team members

• Strong organizational and written and verbal communication skills

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.