1246 claims quality assurance analyst jobs found

Company Shared Services Argo and Farm Family are specialty property and casualty insurance brands whose underwriting companies are wholly-owned subsidaries of Clearbrook Holdings Inc. Argo and Farm Family partner with agents and brokers to provide insurance solutions that enable businesses to manage risks with confidence. Job Description Summary: The Sr Data Analyst partners with stakeholders across P&C Operations (Underwriting, Product, Actuarial, Claims, and Marketing) to deliver advanced analytical insights that inform business strategy and operational decision-making. This role’s responsibility includes performing data analysis (e.g., conceptualization, mining/modeling, and presentation of data) and developing methods to efficiently capture, manage, and analyze data. The position serves as a trusted partner to business leaders by translating complex data into clear, actionable insights and identifying opportunities to improve processes and outcomes. This...

The Procurement Analyst plays a critical role in supporting Enhanced Bill Review Programs by securing essential medical documentation, including itemizations and medical records needed to process claims accurately and efficiently. This position involves proactive outreach to providers, managing inbound inquiries, and ensuring all documentation meets quality and compliance standards, including HIPAA regulations. The Procurement Analyst is detail-oriented, organized, and thrives in a fast-paced environment where meeting production goals and collaborating with team members are key to success. This is an onsite position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Spend approximately 80-85% of the shift making outbound calls to providers to obtain required information; may also send email or fax requests Respond to inbound calls regarding claim status and related inquiries Maintain accurate records of all communications between the company, providers, and...

We are adding an  OIPA Business Solutions Analyst t o our team!    Who We Are: Since 1909, NGL Insurance Company (NGL) has been one of America’s most successful and highly rated independent life insurance companies. We specialize in a suite of innovative products for life’s journey, giving people the financial stability, careful guidance and peace of mind to lead a life filled with confidence, dignity and grace.   NGL's Core Values – integrity, dependability, collaboration, compassion and growth are a foundation of our company and help to build on the interactions we have with our policyholders, partners, funeral homes and each other. We believe in creating an inclusive, welcoming environment for all where diversity is celebrated, and everyone is encouraged to live their best, most authentic self. We offer  Employee Resource Groups for employees to get involved, learn, network, and offer professional and personal development opportunities. With over 100...

Crum & Forster Company Overview Crum & Forster (C&F) , with a proud history dating to 1822, provides specialty and standard commercial lines insurance products through our admitted and surplus lines insurance companies. C&F enjoys a financial strength rating of "A+" (Superior) by AM Best and is proud of our superior customer service platform. Our claims and risk engineering services are recognized as among the best in the industry. Our most valuable asset is our people: more than 2500 employees in locations throughout the United States. The company is increasingly winning recognition as a great place to work, earning several workplace and wellness awards for four years running, including the 2025-2026 Great Place to Work® Award for our employee-first focus and our steadfast commitment to diversity, equity and Inclusion. C&F is part of Fairfax Financial Holdings, a global, billion dollar organization.  For more information...

The Functional Analyst, Senior is responsible for gathering, analyzing, and documenting business or system processes and requirements for NJM’s applications. This role will work closely with all Project, Business team members and Solution Owners throughout the project lifecycle. This role may be required to lead other team members and coordinate work efforts, assist in problem and solution scoping, effectively communicate requirements, and may get involved in quality assurance. Essential Duties and Responsibilities: Strategy Analysis: Consistently support the alignment of business strategy with system implementations by assisting in the support of the FA team and engaging in the following: Collaborating with SO, BPU, and stakeholders to analyze business needs, ensuring that the intent and outcomes are clearly defined and can be translated into requirements that are clear, concise, and complete and achieve desired business outcomes. Collaborating with SO, BPU,...

Ability Analyst - C410AN Sr Ability Analyst - C409AN We’re determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every opportunity to achieve your goals – and to help others accomplish theirs, too. Join our team as we help shape the future.           This role requires strong analytical expertise, strategic thinking, and communication skills to accurately adjudicate PFML claims. As Ability Analyst, you will play a critical role in supporting individuals during some of the most challenging times in their lives. You will be responsible for managing a caseload of PFML claims of moderate complexity, ensuring each claim is handled with empathy, accuracy, and efficiency. This role requires a balance of analytical thinking, customer service, and regulatory compliance. You will serve as the primary point of contact for claimants, employers, and medical professionals,...

This is an opportunity to join Ascot Group - one of the world’s preeminent specialty risk underwriting organizations. Designed as a modern-era company operating through an ecosystem of interconnected global operating platforms, we are bound by a common mission and purpose: One Ascot. Our greatest strength is a talented team who flourish in a collaborative, inclusive, and entrepreneurial culture, steeped in underwriting excellence, integrity, and a passion to find a better way, The Ascot Way. The Ascot Way guides our people and our organization. Our underwriting platforms collaborate to find creative ways to deploy our capital in a true cross-product and cross-platform approach. These platforms work as one, deploying our capital creatively through our unique Fusion Model: Client Centric, Risk Centric, Technology Centric. Built to be resilient, Ascot maximizes client financial security while delivering bespoke products and world class service — both pre- and post-claims. Ascot...

Actuarial Analyst At AIG, we are reimagining the way we help customers to manage risk. Join us as an Actuarial Analyst to take on key responsibilities within a world-class actuarial function. Make your mark in Actuarial Our Actuaries are on the front lines, quantifying risk, pricing insurance and reserving losses for AIG’s major insurance operating companies, globally. We collaborate with Finance, Claims, Operations, Marketing and Risk Management, among other functions. As an AIG actuary, you will be challenged and encouraged to reach your greatest potential to help improve how we predict, manage and mitigate risk. How you will create an impact The North America Rater Delivery Team within Global Pricing – Actuarial develops commercial rating solutions for underwriting teams within AIG, while supporting strategic initiatives within the actuarial team. The North America Rater Delivery Team works alongside international counterparts, Product Actuaries, Underwriters,...

Primary Details Time Type: Full time Worker Type: Employee Claims Compliance Analyst (Workers Compensation) Location: USA –Madison, WI Work Arrangement: Hybrid   The salary range for this role is:  $69,500-$114,500K The Opportunity The Compliance Analyst ensures adherence to regulatory requirements impacting Workers’ Compensation and Professional Liability claims through ongoing monitoring, assessment, and implementation of required actions. The role maintains key regulatory resources, communicates changes to stakeholders, and partners with cross-functional teams to support compliant processes and documentation. Responsibilities include facilitating regulatory examinations and managing required reporting and data submissions. The position also conducts compliance-focused audits and oversees critical federal and state reporting obligations. Your new role Responsibilities: Assist in engaging with the business for the strategic...

This is an opportunity to join Ascot Group - one of the world’s preeminent specialty risk underwriting organizations. Designed as a modern-era company operating through an ecosystem of interconnected global operating platforms, we’re bound by a common mission and purpose: One Ascot. Our greatest strength is a talented team who flourish in a collaborative, inclusive, and entrepreneurial culture, steeped in underwriting excellence, integrity, and a passion to find a better way, The Ascot Way. The Ascot Way guides our people and our organization. Our underwriting platforms collaborate to find creative ways to deploy our capital in a true cross-product and cross-platform approach. These platforms work as one, deploying our capital creatively through our unique Fusion Model: Client Centric, Risk Centric, Technology Centric. Built to be resilient, Ascot maximizes client financial security while delivering bespoke products and world class service — both pre- and post-claims....

The Procurement Analyst plays a critical role in supporting Enhanced Bill Review Programs by securing essential medical documentation, including itemizations and medical records needed to process claims accurately and efficiently. This position involves proactive outreach to providers, managing inbound inquiries, and ensuring all documentation meets quality and compliance standards, including HIPAA regulations. The Procurement Analyst is detail-oriented, organized, and thrives in a fast-paced environment where meeting production goals and collaborating with team members are key to success. This is an onsite position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Spend approximately 80-85% of the shift making outbound calls to providers to obtain required information; may also send email or fax requests Respond to inbound calls regarding claim status and related inquiries Maintain accurate records of all communications between the company, providers, and...

Join us as a Claims Analyst IV, Lex Pro to take on key responsibilities within a world-class claims function. Make your mark in Claims The Claims Analyst IV, Lex Pro position is responsible for handling a caseload of pending and incoming employment practices liability and management liability claims. The analyst will determine coverage, evaluate liability, assess damages, establish appropriate reserves and handle all aspects of claims tendered on architects & engineers professional liability policies. The analyst will communicate extensively with insureds, brokers, and counsel to resolve matters and provide appropriate information and updates to all stakeholders. The analyst will also collaborate with underwriters and senior claims management as necessary to support the business. How you will create an impact Focused on Employment Practices Liability and Management Liability, you will be responsible for a portfolio of claims from coverage inquiry through legal...

The Repricing Quality Assurance Analyst is responsible for reviewing, analyzing, and monitoring repricing audit data across multiple platforms to ensure accuracy, compliance, and efficiency. Works closely with internal teams to maintain contractual and organizational standards, enhance operational effectiveness, and improve client satisfaction. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identify and resolve quality issues within repricing processes Develop and implement QA policies and procedures Monitor compliance with pricing guidelines and contractual requirements Investigate repricing discrepancies and apply corrective actions Prepare QA reports and documentation Collaborate with stakeholders to align quality objectives Provide training and guidance on repricing standards Conduct risk assessments to mitigate potential errors Maintain confidentiality of client data, PHI, and PII Additional duties as assigned...

The Functional Analyst, Senior is responsible for gathering, analyzing, and documenting business or system processes and requirements for NJM’s applications. This role will work closely with all Project, Business team members and Solution Owners throughout the project lifecycle. This role may be required to lead other team members and coordinate work efforts, assist in problem and solution scoping, effectively communicate requirements, and may get involved in quality assurance. Essential Duties and Responsibilities: Strategy Analysis:  Consistently support the alignment of business strategy with system implementations by assisting in the support of the FA team. Business Analysis/Elicitation Skills :  Consistently ensure that the business need is understood and articulated clearly by performing, and assist in supporting the FA team members. Requirements Life Cycle Management:  Consistently achieving deliveries that reflect business outcomes by collaborating with the...

At Genworth, we empower families to navigate the aging journey with confidence. We are compassionate, experienced allies for those navigating care with guidance, products, and services that meet families where they are. Further, we are the spouses, children, siblings, friends, and neighbors of those that need care—and we bring those experiences with us to work in serving our millions of policyholders each day.  We apply that same compassion and empathy as we work with each other and our local communities. Genworth values all perspectives, characteristics, and experiences so that employees can bring their full, authentic selves to work to help each other and our company succeed. We celebrate our diversity and understand that being intentional about inclusion is the only way to create a sense of belonging for all associates. We also invest in the vitality of our local communities through grants from the Genworth Foundation, event sponsorships, and employee volunteerism....

Company Shared Services Argo and Farm Family are specialty property and casualty insurance brands whose underwriting companies are wholly-owned subsidaries of Clearbrook Holdings Inc. Argo and Farm Family partner with agents and brokers to provide insurance solutions that enable businesses to manage risks with confidence. Job Description Argo Group, through its operating subsidiaries, offers high-quality commercial Property and Casualty (P&C) insurance products and services tailored to the needs of businesses and public entities. At Argo Group, we leverage the success, discipline and expertise of our people and an understanding of our customers’ needs to provide a diverse portfolio of products and services. This approach helps those we insure drive down their ultimate cost through prevention and aggressive claims handling. Simply stated, our products and services help keep businesses in business. Argo Group US currently has a challenging opportunity for a  Senior...

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance IT Software Development Advisor Sr PRIMARY PURPOSE OF THE ROLE: To lead a team in the design, development, maintenance, testing and debugging of software; to formulate/define system scope and objectives for assigned projects; to devise or modify procedures to solve complex problems; to prepare detailed specifications from which programs will be written; to be responsible for quality assurance reviews; may be responsible for project completion and user satisfaction; and...

Company Details   Berkley Accident and Health  is a risk management company that designs innovative solutions to address the unique challenges of each client. With our entrepreneurial culture and a strong emphasis on analytics, we can help employers better manage their risk. We offer a broad range of products, including employer stop loss, benefit captives, provider stop loss, HMO reinsurance, and specialty accident. The key to Berkley’s success is our nimble approach to risk – our ability to quickly understand, think through, and devise a plan that addresses each client’s challenges, coupled with the strong backing of a Fortune 500 company. Our parent company,  W. R. Berkley Corporation , is one of the largest and best managed property/casualty insurers in the United States. #LI-AV1 #LI-HYBRID The Company is an equal employment opportunity employer. Responsibilities This role will be based in our Hamilton...

Our employees are at the heart of what we do: helping people, businesses and society prosper in good times and be resilient in bad times. When you join our team, you are bringing this purpose to life alongside a passionate community. Feel empowered to learn and grow while being valued for who you are. At Intact, we commit to supporting you in reaching your goals with tools, opportunities, and flexibility. It’s our promise to you.  Who we are At Intact Insurance Specialty Solutions, we are experts at what we do in protecting what makes businesses unique. Our deep understanding of the specialty insurance market is the foundation for our customized solutions, backed by targeted risk control and claims services. Our employees are passionate about providing insurance coverage that’s aligned to our targeted customer groups. Intact’s Global Specialty Lines business spans across more than 20 verticals in four distinct markets: U.S., Canada, UK and Europe. The following...

Job Description Join us as a Claims Analyst III to take on key responsibilities within a world-class claims function. Make your mark in Claims As a Claim Analyst III, you will be responsible for handling all aspects of multi-line, financial lines claims from inception through conclusion brought against insureds.   The responsibilities for this role include making coverage determinations, investigating losses, evaluating, and projecting potential exposures, setting judgmental reserves, developing and implementing resolution strategies, managing outside law firms, working with underwriting on policy renewals and promoting client relationships. How you will create an impact You will be responsible for a portfolio of claims from coverage inquiry through legal liability assessment and quantum analysis, to timely and accurate resolution. Your goal will be timely, accurate and customer-focused claim resolution, minimizing indemnity...