TPA Performance Specialist
US
careers
Req #: 20160
Type: Regular Full-Time
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Overview: 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. This position will require hybrid attendance in an AmTrust location and is posted remotely for nationwide visibility. Responsibilities: * 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. Qualifications: * 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. #LI-BL1
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