Senior Claims Quality Improvement Specialist

Farm Family

Omaha (NE)

On-site

USD 85,000 - 120,000

Full time

9 days ago

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Job summary

Farm Family in Omaha seeks a Senior Quality Improvement Specialist to perform data-driven claim audits and assess adherence to enterprise standards. The role involves evaluating coverage analysis, reserving, and regulatory compliance while providing actionable feedback to claims management.

The ideal candidate will translate audit findings into measurable quality improvements, supporting training and process changes.

Qualifications

Bachelor’s degree from an accredited university required.
Two years of direct auto, bodily injury, liability, or PIP handling experience.
Two or more insurance designations or four extra years of related experience may substitute for a degree.
Strong written and verbal communication skills for summaries and reports.
Ability to translate audit findings into measurable improvements and actions.

Responsibilities

Conduct and document data-driven claim audits to evaluate handling and outcomes.
Evaluate files for adherence to standards, including coverage, reserving, and regulatory requirements.
Translate audit results into training, process improvements and performance actions.
Escalate critical findings and provide feedback to leadership for urgent claims.
Collaborate in calibration activities to ensure scoring consistency.
Support training initiatives and process improvements with leadership.