Claim Quality Review Senior Consultant – Workers’ Compensation-CLA0001W9
Technical expert for assigned line of business, reports to Claim Quality Review Director and works closely with the Claim Quality Technical Lead. Responsible for reviewing and evaluating Claim files for the assigned line of business to determine whether the desired behaviors that result in quality Claim outcomes are present. Calibrates completed reviews with Claim Quality Technical Lead to identify best practice and opportunity areas. Role expected to be a 12 – 24 month rotational assignment, offering a development opportunity for Claim professionals to gain clear insight on quality and behaviors that impact results.
Essential Duties & Responsibilities
Completes technical file reviews for assigned line of business; gathers and interprets data, evaluating both technical and operational behaviors associated with functional roles.
Works with the Claim Quality Review Director and the Claim Quality Technical Lead for assigned line of business to aggregate and analyze results from quality and manager reviews to identify trending of best practice and opportunity areas for assigned line of business and across the Claim organization.
Periodically serves as support for the Claim Quality Technical Lead in the assigned line of business.
Participates in Compliance related reviews, as necessary.
Reviews Claim customer survey results to identify trends, best practices and improvement opportunities for assigned line of business.
Stays current on industry trends and developments.
May perform additional duties as assigned.
Typically Director or above
Skills, Knowledge & Abilities
A solid understanding of the insurance industry, its practices and operations. Technical knowledge in assigned line of business.
Advanced analytical and problem solving skills with ability to manage and prioritize multiple projects.
Strong project management skills.
Excellent communication, presentation and interpersonal skills with the ability to work effectively with internal business partners.
Ability to influence others in accepting ideas that will lead to increased business results.
Strong computer skills including Microsoft Office Suite and other business related software systems.
Education & Experience
Bachelor’s degree or its equivalent. Applicable professional designations preferred.
Typically a minimum of eight years of related work experience in the insurance industry with strong line of business technical expertise.
EEO Statement: CNA is an Equal Opportunity Employer committed to a diverse work culture. M/F/D/V.
CLAIM-Quality Compl & Learning
Consulting , Insurance , Insurance Claims