Claims Quality Analyst

West Bend Mutual Insurance Company; West Bend (WI); Hybrid; USD 75,000 - 95,000; Full time

Benefits offered by this job

401(k) Plan with Company Match

Paid Time Off

Medical Insurance

Job summary

West Bend Mutual Insurance Company is seeking a Claims Quality Analyst to support the Claims Quality Assurance team. This hybrid role may involve remote work with occasional in-person engagement within the Wisconsins offices and travel as needed.

You will review casualty files, analyze audit results, and report on trends while partnering with Claims leaders and Training teams to raise the quality and consistency of claim handling.

Qualifications

• 7 years of claims handling experience.
• 3 years of claims auditing experience.
• Experience with auto, bodily injury, and general liability claims.
• Strong knowledge of regulatory requirements and industry standards.
• Analytical mindset with ability to recognize meaningful patterns.
• Strong written and verbal communication skills.
• Experience coaching or mentoring others.

Responsibilities

• Review casualty claim files for quality, compliance, and adherence to best practices.
• Conduct claims performance reviews and analyze audit results for trends.
• Manage auditing database and select files for review; develop reporting.
• Share findings with Claims leadership in a clear, practical way.
• Serve as a casualty claims resource for Claims and Training teams.
• Partner with reviewers to provide guidance and consistency in audits.
• Provide technical guidance on low to moderate complexity issues.
• Build relationships with stakeholders across Claims and organization.
• Tackle targeted audits and emerging quality questions as needed.

Skills

Claims auditing

Analytics

Regulatory knowledge

Communication

Mentoring

Education

Bachelor's degree in Communications, Education, Business

Insurance designations CPCU, AIC, AINS preferred

Tools

Databases

Reporting tools

Audit software

Job description

Claims Quality Analyst

Job Locations

US-WI-West Bend

Category: Claims

Contract: Full-Time

Work Arrangement: Hybrid

Company Overview

Recognized as a Milwaukee Journal Sentinel Top Workplace for 14 consecutive years, including three years of being honored as number one! Join us at West Bend, where we believe that our associates are our greatest asset. We hire talented individuals who are conscientious, dedicated, customer focused, and able to build lasting relationships. We create and maintain an environment where you feel a sense of belonging and appreciation. Your diversity of thought, experience, and knowledge are valued. We're committed to fostering a welcoming culture, offering you opportunities for meaningful work and professional growth. More than a workplace, we celebrate our successes and take pride in serving our communities.

Job Summary

Supports the Claims Quality Assurance team to ensure claims handling compliance and adherence to West Bend's Best Practices, policies, and adjusting procedures.

Work Location

This position offers both remote and hybrid work locations. Candidates who reside within 50 miles of an office location (West Bend, Madison, Appleton) will be offered a hybrid work schedule. Candidates who are fully remote (beyond 50 miles) may occasionally be asked to travel to an office location for in-person engagement activities such as team meetings, training and corporate events.

Responsibilities & Qualifications

You know what strong claim handling looks like. In this role, you'll help us understand where it's happening consistently, and where there may be opportunities to get better.

As part of our Claims Quality Assurance team, you'll take a close look at casualty claim files, audit results, and performance trends to provide an objective view of claim quality across the organization. It's a role for someone who enjoys getting into the details of a file, asking the right questions, and turning what they find into useful feedback for Claims leaders and teams.

Your work will include:

• Reviewing casualty claim files to assess quality, compliance, and adherence to West Bend's best practices, policies, and adjusting procedures.
• Conducting claims performance reviews and analyzing audit results to identify trends and areas that deserve a closer look.
• Managing the audit database, selecting and deploying files for review, and developing reporting that helps tell the story behind the results.
• Sharing findings and recommendations with Claims leadership in a clear, practical way.
• Serving as a casualty claims resource for both the Claims and Training teams.
• Partnering with reviewers to provide guidance, calibration, and greater consistency throughout the audit process.
• Providing technical guidance and coverage interpretation on issues of low to moderate complexity.
• Building productive relationships with stakeholders across Claims and other areas of the organization.
• Taking on targeted audits, special projects, and emerging quality questions as needs arise.

The Experience That Will Help You Succeed

This role calls for someone who understands casualty claims beyond the surface level and can balance the details of an individual file with the bigger picture.

We'd especially value

• 7 years of claims handling experience, with experience in auto investigations, bodily injury, and general liability claims.
• 3 years of claims auditing experience.
• Experience working with complex or large claim files.
• Strong knowledge of regulatory requirements and insurance industry standards.
• An analytical mindset and the ability to recognize meaningful patterns in audit results and claims data.
• Strong attention to detail without losing sight of the broader issue.
• The ability to explain complex claims concepts, findings, or data in a straightforward way.
• Strong communication skills and the ability to work effectively with Claims professionals and leadership.
• Experience coaching, mentoring, or helping others build their technical knowledge.
• Comfort working with current technology, databases, and reporting tools.

Education & Credentials

• Bachelor's degree in Communications, Education, Business, or a related field preferred.
• Insurance designations such as CPCU, AIC, or AINS are preferred.

A Different Way to Use Your Claims Experience

For someone who has spent years handling claims, this role offers a chance to use that experience from a different perspective. Rather than owning an individual caseload, you'll be looking across files, identifying patterns, asking why they're happening, and helping turn those observations into better, more consistent claim handling.

#LI-BW1

Benefits

West Bend offers a comprehensive benefit plan including but not limited to:

• Medical & Prescription Insurance
• Health Savings Account
• Dental Insurance
• Vision Insurance",

  Benefits

  West Bend offers a comprehensive benefit plan including but not limited to:

  • Medical & Prescription Insurance
  • Health Savings Account
  • Dental Insurance
  • Vision Insurance
  • Short and Long Term Disability
  • Flexible Spending Accounts
  • Life and Accidental Death & Disability
  • Accident and Critical Illness Insurance
  • Employee Assistance Program
  • 401(k) Plan with Company Match
  • Pet Insurance
  • Paid Time Off. Standard first year PTO is 17 days, pro-rated based on month of hire. Enhanced PTO may be available for experienced candidates
  • Bonus eligible based on performance
  • West Bend will comply with any applicable state and local laws regarding employee leave benefits, including, but not limited to providing time off pursuant to the Colorado Healthy Families and Workplaces Act for Colorado employees, in accordance with its plans and policies.

  EEO

  West Bend provides equal employment opportunities to all associates and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

  This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, and promotion.