Claims Quality Data Analyst
Role details
Job location
Tech stack
Job description
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Compiles data and identifies differences for leads to conduct meetings for coaching and performance of auditors
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Participates in the development of dashboards to drive data-driven decision making and to identify file quality trends and patterns
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Analyzes data to identify problems with audit deployment, audit set up and activation
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Visualize data with graphs, infographics and other methods
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Ensures monthly claim quality file review deployments are balanced for all business lines including auditors and managers according to preset criteria and qualifications
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Validates accuracy of Loss Run Data Files for all companies and all business lines and ensures timely receipt, accurate data and proper file distribution
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Generates manual audits for any reviews required, including sample selection, deployment and drafting attachments for reports
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Utilizes the claim file quality audit tool to improve reporting and analytic outputs and data presentation
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Monitors, adjusts and manages business rules for audit deployment on a monthly basis
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Manages internal requests to add and remove files from the sample following business rules and guidelines
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Troubleshoot various levels of issues between vendor and ACG with audit deployments, reports, etc.
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Obtains data from vendor systems and compile spreadsheets for vendor to assign manual audits on a monthly basis for PD Field, Total Loss and Litigated claims
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Trains new managers on reporting functions of the claim audit tool
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Assigns Work Product Quality and Calibration reviews for the audit teams,
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Functions as a liaison between the audit team and the managers conducting audits regarding audit deployment and reporting
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Functions as a liaison between auditors and the audit tool vendor on design and deployment
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Generates custom reports upon request, Serve as the Claims Quality data and reporting liaison regarding claim file audit deployment and data analysis. Ensures consistency and reliability in activities related to audit file deployment, tracking and reporting including smooth distribution of monthly assignments for all audit types. Act as the subject matter expert on the rules and processes used to assign and distribute monthly audits.
Requirements
Do you have a valid Driver's License license?, Do you have experience in Task prioritization?, Education (include minimum education and any licensing/certifications):
- College coursework or equivalent
- Three years of experience in data analysis or data processing
- A valid driver's license is required if the primary responsibilities of the role involve conducting in-person inspections or frequent in-person meetings with members.
Experience:
- Analyzing data to prepare reports
- Utilizing computer software applications (e.g. Word, Excel, PowerPoint, Power BI, SharePoint, google cloud platform) to format data bases, write queries, generate reports, etc.
- Prioritizing work assignments
- Coordinating and controlling data-related projects
- Designing and summarizing data
- Identifying, researching and resolving moderate to complex business problems
- Business planning and consulting to meet reporting needs across the claim's organization
Skills and Ability to:
- Format and prepare reports
- Communicate effectively in a work environment
- Explain statistics and interpret data
- Prepare and present reports and recommendations
- Work in a team environment
- Perform a variety of concurrent activities
- Strong interpersonal, communication skills, including report preparation and presentation also investigative, analytical skills
- Understand claim handling procedures and the complete claim lifecycle
III. Preferred Qualifications
Experience:
- Demonstrate strong experience in Tableau or other related tools
- Developing or using software to develop predictive models
- Analyzing and summarizing data with Tableau or a similar tool
- Project planning/management including research and analysis and delivery
- Experience/exposure to quality audit practices, internal controls and implementation of quality standards within an insurance or related industry
Knowledge of:
- ACG claims policies and procedures, terminology and processing systems
- Claims policy provisions, principles and concepts
- Data modeling for Six Sigma or other similar projects
IV. Work Environment
This position is currently able to work remotely from a home office location for day-to-day operation unless occasional travel for meetings, collaborative activities, or team building activities is specified by leadership. This is subject to change based on amendemnts and/or modifications to the ACG Flex Work policy
Important Note:
The above statements describe the principle and essential functions, but not all functions that may be inherent in the job. This job requires the ability to perform duties contained in the job description for this position, including, but not limited to, the above requirements. Reasonable accommodations will be made for otherwise qualified applicants, as needed, to enable them to fulfil these requirements.
Benefits & conditions
3.13.1 out of 5 stars Michigan $51,854.40 - $74,890.00 a year - Full-time, Pulled from the full job description
- Tuition reimbursement
- Health insurance
- 401(k) matching
- Paid time off
- Vision insurance
- Dental insurance
- Paid holidays