Senior Claims Quality & Audit Analyst – Hybrid

Milwaukee Succeeds; West Bend (WI); Hybrid; USD 70.000 - 95.000; Vollzeit

Benefits dieser Stelle

Medical & Prescription Insurance

Health Savings Account

Dental Insurance

Vision Insurance

401(k) Plan with Company Match

Paid Time Off

Zusammenfassung

West Bend seeks a seasoned Claims Quality Analyst to join our Claims Quality Assurance team in Wisconsin. You will review casualty claim files, audit results, and performance trends to drive quality and compliance with best practices and regulatory standards.

This role offers remote or hybrid work; candidates within 50 miles of West Bend, Madison, or Appleton will have a hybrid schedule, with occasional in-person meetings and training as needed.

Qualifikationen

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

Aufgaben

• Review casualty claim files to assess quality, compliance, and adherence to best practices.
• Conduct claims performance reviews and analyze audit results to identify trends.
• Manage the audit database, select files for review, and create reporting.
• Share findings and recommendations with Claims leadership clearly and practically.
• Serve as a casualty claims resource for Claims and Training teams.
• Partner with reviewers to provide guidance and consistency in audits.
• Provide technical guidance and coverage interpretation on low to moderate complexity issues.
• Build productive relationships with stakeholders across Claims and other areas.
• Take on targeted audits, special projects, and emerging quality questions.

Kenntnisse

Claims handling

Analytical mindset

Communication skills

Mentoring / coaching

Regulatory knowledge

Ausbildung

Bachelor's degree in Communications, Education, Business, or related field

Insurance designations CPCU, AIC, or AINS (preferred)

Jobbeschreibung

West Bend seeks a seasoned Claims Quality Analyst to join our Claims Quality Assurance team in Wisconsin. You will review casualty claim files, audit results, and performance trends to drive quality and compliance with best practices and regulatory standards.

This role offers remote or hybrid work; candidates within 50 miles of West Bend, Madison, or Appleton will have a hybrid schedule, with occasional in-person meetings and training as needed.