12/04/2025
The Quality Assurance Specialist reviews and evaluates samples of claim files for compliance with Best Practices and State Regulations. Aiding in the company meeting the prompt and fair settlement loss standards, within the provisions of the insuring agreement and all applicable insurance regulations. They are responsible for creating value in the review process by identifying areas of opportunity for improvement and/or training in individual reviews and claim processes. They communicate all findings in a professional, effective and supportive manner with examiners and management.
Duties & Responsibilities:
Perform Focus Audits to check for compliance as requested by management.
Applicable divisional Regulation reviews.
Reg 118 reviews.
ISO System to System Audits.
Review samples of claims for valid and applicable coverage.
Review claims for proper coverage verification.
Determine loss exposure and appropriate reserves as applicable.
Review and analyze...
NYCM Insurance
Edmeston, NY, USA
Full Time
