TPA Quality Assurance Specialist - Liability Lines

Responsible for executing quality reviews on claims for Commercial Liability lines of coverage. Engages with claim leadership to discuss feedback and training with the various claim departments. Partners with key stakeholders to improve compliance with claim quality standards and reduction of leakage. Acts as a trusted advisor for the business. Maintains a solid understanding of AmTrust's mission, vision, and values. Upholds the standards of the AmTrust organization.

Conduct Claim File Audits:Regularly review claim files to ensure compliance with company standards and regulatory requirements.

• Provide Feedback:Offer constructive feedback on audit results and suggest improvements to enhance claim processing quality.

• Develop Quality Improvement Strategies:Assist in creating and implementing strategies to improve the overall quality of claims handling.

• Training and Support:Assist in providing training sessions to claims staff to improve their knowledge and skills.

• Analyze Data:Create and review reports on claim quality trends to identify areas of opportunity and make recommendations for process improvements.

• Customer Relations:Work with claim teams on corrective action plans

• Creates consumable reports and delivers assessment results to the appropriate level of leadership and applicable stakeholders.

• Analyzes and interprets data to monitor trends, identify root causes, and partners with the business to proactively isolate issues and support the development of measurable action plans.

• Prioritizes tasks effectively, meeting assessment/project due dates, and identifies and escalates competing demands and/or dependencies.

• Develops and maintains a strong understanding of QA methodologies, tools, and risk management principles.

• Keeps current with market trends and demands.

• Performs other duties as assigned.

• Bachelor's Degree in related field OR equivalent business experience.

• 5+ years of related claims experience, with recent background in a quality or compliance oversight role.

• Strong oral and written communication skills.

• Ability to evaluate, prioritize and make informed decisions to ensure timely and accurate completion of all assignments.

• Applicable claims, compliance, risk, and/or legal designations such as ARM, AIC, CRCMP, CLMP, ARC, CPCU, SCLA, or IRES designations desirable.
• Licensing:A valid adjuster license may be required, depending on the state and company regulations

This role is essential for maintaining the integrity and efficiency of the claims process, ensuring that customers receive accurate and timely service.

AmTrust Financial Services offers a competitive compensation package and excellent career advancement opportunities. Our benefits include: Medical & Dental Plans, Life Insurance, including eligible spouses & children, Health Care Flexible Spending, Dependent Care, 401k Savings Plans, Paid Time Off.

AmTrust strives to create a diverse and inclusive culture where thoughts and ideas of all employees are appreciated and respected. This concept encompasses but is not limited to human differences with regard to race, ethnicity, gender, sexual orientation, culture, religion or disabilities.

AmTrust values excellence and recognizes that by embracing the diverse backgrounds, skills, and perspectives of its workforce, it will sustain a competitive advantage and remain an employer of choice. Diversity is a business imperative, enabling us to attract, retain and develop the best talent available. We see diversity as more than just policies and practices. It is an integral part of who we are as a company, how we operate and how we see our future.