Claims Quality Assurance Manager

Hippo Insurance; Dallas (TX); On-site; USD 93,000 - 138,000; Full time

Job summary

Hippo Insurance is seeking a Claims Quality Assurance Manager to enhance claims quality and compliance processes. Ideal candidates will have over 5 years in claims management, with strong audit and oversight skills. Join a forward-thinking company committed to innovation in the insurance industry, where you'll lead internal audits and drive improvements in claims processing.

Benefits

Health insurance plans with employer coverage

Equity compensation options

Training and career growth opportunities

Flexible time off

Parental leave for caregivers

Access to onsite snacks and drinks

Qualifications

• Advanced skills in claims handling, including investigation and customer service.
• Exceptional business judgment with effective decision-making frameworks.
• Ability to quickly utilize existing claims handling systems.

Responsibilities

• Develop and implement program review standards for claims.
• Conduct internal audits and compliance checks related to claims.
• Provide feedback to enhance compliance and best practices.

Skills

Coverage analysis

Litigation management

Negotiation

Fraud detection

Auditing

Problem-solving

Education

5+ years of experience in claims

Knowledge of state laws and regulations

Auditing experience

Job description

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Join to apply for the Claims Quality Assurance Manager role at Hippo Insurance

Reporting to: Director of Sales Operations

About Hippo:

Hippo exists to protect the joy of homeownership. We believe that insurance should protect the things you treasure through an intuitive, modern experience. We provide tailored insurance coverage and preventative maintenance plans that keep you protected throughout your homeowner journey. We’ll also help you find coverage for everything life brings—from auto to flood—reimagining how you care for your home.

About This Role:

We are seeking an experienced Claims Quality Assurance Manager to join our team reporting to our Director of Sales Operations. This role will help develop and implement program review standards for claims quality, consistency, and compliance and conduct claim file reviews. Then, in partnership with key internal claims stakeholders evaluate processes and internal controls to identify gaps and risks. You will provide feedback to ensure compliance is maintained and assist in training and knowledge sharing relating to claims best practices and risk identification and mitigation. Audits will assist in optimizing program and individual adjuster’s level of review and overall performance and provide the foundation and support to make sure department goals are consistently met.

About You:

You are a team player who enjoys helping and developing others, and an overachiever driven to exceed expectations. You communicate effectively with individuals at all levels of an organization and are enthusiastic about working for a company that focuses on disrupting the norm. As a critical thinker, you excel at recognizing irregularities and preventing fraud. You are also comfortable conducting regular internal audits and risk assessments to identify and correct areas of non-compliance.

What You'll Do:

• Create an ongoing audit process
• Conduct end-to-end review for claims
• Perform claims audits of best practices of nonaffiliated programs of the Company
• Review adherence to Hippo’s Claims and Estimating Guidelines and legal compliance
• Identify/verify:
• Coding and math errors
• Claims leakage
• Prepare necessary reports with detailed documentation and citations to substantiate findings and corrective action plans
• Provide internal management and external programs with clear and actionable recommendations for process improvements and adjustments
• Develop and implement quality and compliance standards
• Facilitate compliance-related matters such as market conduct exams, and other requirements typical in a claims department
• Train staff on regulatory and claim compliance, including remedial training in response to gap analysis

Must Haves:

• 5+ years of successful handling of claims including advanced skills in coverage analysis, investigation, litigation management, negotiation, damage evaluation, customer service, vendor management, fraud detection, salvage, and subrogation
• Exceptional business judgment with the ability to create sound frameworks to drive decisions and organizational alignment
• Knowledge of and adherence to, the state laws and regulations governing the handling of property and casualty claims throughout the United States
• Excellent time management and organizational skills
• Prior auditing experience in a senior role
• Ability to quickly understand and utilize existing and future claims handling systems.
• Knowledge of best practice claims workflow as well as compliance guidelines
• Effective research and problem-solving skills, and the ability to multitask
• Has excellent communication skills and attention to detail

Nice to Haves:

• Management/Supervisory experience is a plus

Benefits and Perks

Hippo treats its team members with the same level of dedication and care as we do our customers, which is why we’re fortunate to provide all of our Hippos with:

• Healthy Hippos Benefits - Multiple medical plans to choose from and 100% employer covered dental & vision plans for our team members and their families. We also offer a 401(k)-retirement plan, short & long-term disability, employer-paid life insurance, Flexible Spending Accounts (FSA) for health and dependent care, and an Employee Assistance Program (EAP)
• Equity -This position is eligible for equity compensation
• Training and Career Growth - Training and internal career growth opportunities
• Flexible Time Off - You know when and how you should recharge
• Little Hippos Program - We offer 12 weeks of parental leave for primary and secondary caregivers
• Hippo Habitat - Snacks and drinks available for onsite employees

Hippo is an equal opportunity employer, and we are committed to building a team culture that celebrates diversity and inclusion.

Hippo’s applicants are considered solely based on their qualifications, without regard to an applicant’s disability or need for accommodation. Any Hippo applicant who requires reasonable accommodations during the application process should contact the Hippo’s People Team to make the need for an accommodation known.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Quality Assurance

• Industries

  Insurance

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