QI Specialist II

Description

Under moderate or limited direction, may review and analyze PL Core USRM Claims Casualty line of business (LOB) (Casualty PL Core-Attorney Repped, SC/PL Unrepped) to determine alignment with claims handling standards. Assists, participates, and leads internal and external calibration events, analysis of results and insights, development of QI reporting, and presentation of findings to Field leaders and stakeholders. Participates in and/or facilitates operational problem-solving events and provides support for the implementation of improvements.

 

*This 2-year Quality Improvement Rotational Program (QIRP) has been designed to help you deepen your Claims technical and quality expertise and help you build additional capabilities that will prepare you for your next role at Liberty Mutual. 

 

*Candidates who reside within 50 miles of a claims office will be required to go into the office at least two times a month.

 

*This is a lateral position eligible for grades 13.

 

* PL Casualty experience is required or strongly encouraged.

Responsibilities:

• Under limited direction, conducts virtual and on-site quality and/or performance audits of claims files, to include re-inspection of damages if appropriate on less complex claims.
• Analyzes all aspects of claims from notification to recovery claims valued up to $75k with litigation involved.
• Determine compliance with claims handling standards, policies and procedures as determined by calibration.
• Under limited direction, analyzes results and develops the necessary detail from audits conducted to assist the QI team in identifying the trends from an audit which, if corrected, would drive improvement.
• Accurately tracks and inputs audit findings into database.
• Participate in calibration with File Review team and the analysis of overall results.
• Under limited direction, assists in the preparation and leads presentation of results, conclusions and recommendations to field leadership on less complex claims.
• Assists with driving continuous improvements by providing feedback on audit process and tool changes that will result in a better product being delivered to the line of business.
• Performs other duties as assigned.

Qualifications

• Bachelor`s degree required plus minimum 3-5 years of directly related experience required
• Strong written and oral communication skills required
• Strong interpersonal and analytical skills required
• Comprehensive knowledge of Claims department procedures required
• Knowledge of assigned line of business, general insurance policy coverage and State Tort Law

Employees may apply for a new role after completing 12 months of employment in their current position.

 

Employees should review all role requirements and apply only for positions for which they are eligible. Hiring processes may vary by country, including differences in procedures, requirements, and timelines.  For country-specific details, please consult your local recruiting / HR team.

Travel

10%