Claims Quality Assurance Analyst

About the position

Build a brilliant future with Hiscox. We are a fun, innovative and growing Claims Operations team where you’ll get the opportunity to learn multiple insurance products and interact with business leaders across the organization. This role is a crucial component of delivering successful Quality, continuous improvement and helping to shape our Best Practices. The Claims Quality Assurance Analyst completes regular quality reviews of claim files, checking against our regulatory and quality framework while driving improvements across the business. This role ensures that our high standards are consistently applied by the ongoing development, support and embedding of the quality framework, through effective feedback, training and remedial plans where appropriate.

Responsibilities

• Plan and perform internal and TPA claim quality assurance reviews measured against Hiscox Claims Best Practices and regulatory framework and standards.
• Produce qualitative MI and analytical reports which succinctly identify claim findings and trends, as well as prioritize any issues identified.
• Analyze data and effectively communicate audit findings and reports to key stakeholders.
• Review claim outcomes/resolutions in the context of the Hiscox Claim Best Practices or TPA Claim Handling Guidelines, and work with the Claims Quality Assurance Manager to provide constructive and objective feedback, including recommendations for improvements, training and any remedial actions to be taken.
• Oversee and administer the ongoing month to month Claim Review process to ensure all eligible file handlers are reviewed on a continuous basis.
• Plan and prioritize daily, weekly, monthly workload to ensure output targets are achieved.
• Ensure all activity is clearly and concisely documented and recorded in the correct systems.
• Collaborate with the QA team and business units on continuous improvement and training initiatives.
• Be a point of contact for QA queries and support by providing practical advice and guidance.

Requirements

• 3+ years previous claims auditing experience and/or background.
• 5-8 years of multi-line claims handling experience (preferably GL, Professional Liability, and/or Property/Inland Marine lines of business).
• Excellent written and verbal communication skills.
• Demonstrated organizational and time management skills.
• A sound understanding of claims regulatory expectations and operational risk.
• Ability to process information and change focus quickly in line with the ad-hoc nature of anticipatory risk assignments.
• Awareness of market trends, insurance compliance, risk and regulatory issues.

Nice-to-haves

• Subject matter expertise.
• Experience within legal or regulatory compliance.
• Experience with state DOI standards.
• Track record of exceptional customer service.
• Track record of stakeholder management skills.

Benefits

• 401(k) with competitive company matching.
• Comprehensive health insurance, vision, dental and FSA plans (medical, limited purpose, and dependent care).
• Company paid group term life, short-term disability and long-term disability coverage.
• 24 Paid time off days plus 2 Hiscox days, 10 paid holidays plus 1 paid floating holiday, and ability to purchase up to 5 PTO days.
• Paid parental leave.
• 4-week paid sabbatical after every 5 years of service.
• Financial Adoption Assistance and Medical Travel Reimbursement Programs.
• Annual reimbursement up to $600 for health club membership or fees associated with any fitness program.
• Company paid subscription to Headspace to support employees’ mental health and wellbeing.
• 2023 Gold level recipient of Cigna’s Healthy Workforce Designation for having a best-in-class health and wellness program.
• Dynamic, creative and values-driven culture.
• Modern and open office spaces, complimentary drinks.
• Spirit of volunteerism, social responsibility and community involvement, including matching charitable donations for qualifying non-profits via our sister non-profit company, the Hiscox USA Foundation.