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AIG · 2 weeks ago

Claims, Quality Assurance Specialist - Worker's Compensation

Atlanta, GA

Full-time

Hybrid

Mid Level

AIG is a global leader in commercial and personal insurance solutions, and they are seeking a Claims QA Specialist to enhance the quality of claims handling processes. The role involves conducting quality reviews, leading benchmark assessments, and collaborating with business partners to drive continuous improvement in claims management.

BankingFinancial ServicesInsurance

Responsibilities

Complete quality reviews on all files within program guidelines while achieving and maintaining calibrated application of Line of Business best practices and claim handling expectations

Organize and execute Benchmark reviews as a Team Lead, including risk assessment, scheduling, sampling, GQA review team oversight, results analysis, stakeholder feedback, addressing queries and reporting of results

Establish and maintain effective communication with Line of Business partners including presentation of constructive feedback in a positive way

Identification of trends and improvement opportunities with follow-up to ensure implementation of meaningful continuous improvement and/or action plan in partnership with claims

Carry out second-line reviews and provide constructive feedback and training where required to drive calibration with our claims partners

Commitment to personal development and skill enhancement

Qualification

Workers Compensation claimsClaims analysisRegulatory knowledgeStakeholder reportingAttention to detailFeedback presentationCommunication skillsOrganizational skills

Required

Proven claims experience handling and auditing Workers Compensation claims

Excellent awareness of industry practices surrounding Claims Handling together with strong technical knowledge of subject matter and ability to apply it to the role

Knowledge of key regulatory and legal requirements relevant to Workers Compensation claims

Experience in claims analysis, Management Information and stakeholder reporting

Ability to make recommendations on action and improvement plans

Excellent attention to detail

Excellent verbal and written Communication skills, ability to influence and to manage stakeholder expectations

Excellent written output skills with ability to create consistently factual, correct, high quality audit reports and supporting documentation

Ability to address queries, disputes, challenges through the claims audit cycle while maintaining the philosophies of the GQA function

Excellent organizational skills

The role will require to work from other AIG offices (up to 25% travel)