Quality Reviewer II

Reviews property and/or casualty claims to ensure quality and compliance with client instructions and service level agreements. Investigates and analyzes quality trends, recommends solutions and ensures corrections are made.

• Responsible for the review, testing and analysis of complex claim files to ensure quality work products are sent to clients.
• Manages the tracking, reporting and analysis of quality data. Makes decisions regarding the depth of testing required based various criteria including: adjuster, client, and previous/common errors.
• Partners across departments and with other claims technical staff to ensure overall product quality.
• Reviews and verifies information regarding complex claims to ensure the proper processing in accordance with established quality standards.
• Reads and interprets complicated customer and vendor specifications.
• Develops and assesses alternative methods to achieve uniform quality including identifying process variables and training opportunities.
• Verifies corrected material and prepares quality assurance reports as appropriate.
• Analyzes claims and process trends and makes corrective recommendations.
• Continuously monitors performance and reports performance issues to appropriate management to coordinate the corrective action process.
• Identifies best practices and applies these to meet efficiency and cost objectives and ensure measurements are applied to demonstrate results.
• Assist in the training of other QA staff through formal classes when new processes are introduced to help ensure consistency throughout the department.
• Upholds the Crawford Code of Conduct.

• Bachelors degree or equivalent combination of education and experience.
• Five years of experience handling complex property and/or casualty claims and Xactimate experience.
• Audit/quality control experience
• Experience in automated testing of environment is strongly preferred
• Excellent writing and verbal communication skills
• Strong analytical ability
• Attention to detail.
• Ability to work independently in a multi-tasking environment with a sense of urgency
• Must possess critical thinking, interpersonal, problem solving, teamwork, and organizational skills.
• Must have or secure and maintain the appropriate license(s) as required by the state(s) at the adjuster level.
• Must complete continuing education requirements as outlined by Crawford Educational Services