Senior Specialty Claims QA & Compliance Lead

Westfield-Insurance; Westfield Center (OH); On-site; USD 110,000 - 150,000; Full time

Job summary

Westfield-Insurance in Ohio is seeking a Senior Specialty Claims Quality Assurance and Compliance Specialist to support QA, compliance oversight, claims governance, and reporting. You will help ensure claims meet regulatory requirements and internal standards while coordinating governance processes, including licensing, reinsurance reporting, and large losses.

The ideal candidate has seven or more years in Specialty claims and a strong grasp of cyber, financial institutions, management

Qualifications

• Seven or more years of experience in Specialty insurance claims handling, quality assurance, or a related role.
• Strong knowledge of Cyber, Financial Institutions, Management Liability, Professional Lines, and applicable state and federal insurance regulations.
• Demonstrated experience reviewing complex claims and identifying quality, compliance, or control issues.
• Ability to analyze claim data and QA results to identify patterns, trends, and areas of risk.
• Clear written and verbal communication skills and ability to collaborate with leadership.
• Willingness to travel as needed.

Responsibilities

• Provide QA and compliance support to Specialty Claims operations.
• Audit claims for accuracy, completeness, and regulatory compliance.
• Identify trends and control gaps in high-risk, complex claims.
• Oversee AI-enabled claims governance and controls.
• Collaborate with Claims leadership to address findings and corrective actions.
• Prepare QA reports and regulatory/claims reporting.

Skills

Specialty claims QA

Compliance

Quality assurance

Data analysis

Claims reporting

Regulatory knowledge

Guidewire ClaimCenter

Tools

Guidewire ClaimCenter

Job description

Westfield-Insurance in Ohio is seeking a Senior Specialty Claims Quality Assurance and Compliance Specialist to support QA, compliance oversight, claims governance, and reporting. You will help ensure claims meet regulatory requirements and internal standards while coordinating governance processes, including licensing, reinsurance reporting, and large losses.

The ideal candidate has seven or more years in Specialty claims and a strong grasp of cyber, financial institutions, management