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Job Field: Government Jobs
Location: SOUTH JORDAN, UT
Job Type: Full Time

JOB SUMMARY:

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Job Title: Senior Quality Control Auditor Job ID: 23254 Location: Nationwide Full/Part Time: Full-Time Regular/Temporary: Regular This position will perform work under the general supervision of the VP, Claims Quality Control. The role requires performing technical claim audits and training activities for internal and external business partners to valuate claims outcomes, adherence to claims best practices, claim quality, and loss cost leakage. Researches and defines claims policy and practices relevant to scope of job function to satisfy Company and regulatory requirements Monitors the documentation and assessment of claims performance audits to ensure consistent procedures are followed Improves processes within the Company to increase the level and quality of service provided to internal and external customers Contributes to the embedding of claims best practices and quality control policies and procedures in business processes to ensure claims quality Provides advice and guidance to business stakeholders to ensure adherence to claims management strategy Participates and assists in the creation of new audit program deliverables to support improvements in claims quality and leakage avoidance Raises claim quality awareness and concerns to all parties in order to reinforce QBE Standard Operating Procedures. Reviews audit data for accuracy, to ensure audit sample matches required scope of audit. Attention should be paid to key reportable fields allowing enough time to correct errors in time for monthly reports to run. Identify issues, notify appropriate parties and take corrective action as needed. Builds and maintains strong and effective relationships with key internal and external business stakeholders to ensure audit and quality control services are responsive to their needs and expectations Appreciates the needs and demands of internal stakeholders during the audit process so that any issues can be addressed and resolved effectively Provides accurate and timely information to all external and internal stakeholders concerning audit status and other inquires to maintain a no surprises environment Provides technical advice, guidance, and information on claims quality strategy and policy to support understanding and adoption of Standard Operating Procedures Monitors and evaluates developments, industry trends, and best practices to identify merging issues, formulate recommendations to senior leadership, and develop appropriate action plans Increases Company's visibility within the claims community through participation in committees and industry associations and events Leads the reviews and analysis of claims risks to ensure compliance with claims quality control policies and procedures, QBE standards, and industry best practice Assists in pre-audit planning by determining key controls, direction, and approach of proposed audits Performs analysis and review of staff work product through claims performance audits, next level reviews, auditor productivity reports, and assessment of auditor calibration to ensure compliance with Company and regulatory requirements Identifies deviations to assess the quality and loss cost associated with leakage, and state of readiness (calibration) of auditors Interprets audit data for key drivers of leakage/quality and recommends continual improvement action plans Prepares detailed working papers that evidence the work performed and any issues that arise Drafts, prepares, and submits timely and accurate audit findings to management Supports other auditors and line of business in unit as workload may require Provides vendor with feedback in the development of TEAMThink audit questionnaires and reports Communicates claims expectations and ensures best practices are understood and implemented to ensure appropriate performance Provides line of business specific training and support to claim team members in the per

KEY REQUIREMENTS:

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Bachelors