Bodily Injury Quality Assurance Auditor

Job Description

Job Description

Bodily Injury Quality Assurance Auditor

Remote | Claims Department

To be considered for this opportunity, candidates must meet the following requirements:

• Minimum 4+ years of Property & Casualty insurance experience
• Strong technical knowledge of Property & Casualty claims handling
• Experience handling subrogation, property damage, and bodily injury claims
• Knowledge of insurance regulations, compliance requirements, claims handling standards, and industry trends
• Experience conducting claim file reviews, audits, or quality assurance activities
• Strong analytical skills with the ability to identify trends, root causes, and compliance gaps
• Advanced proficiency in Microsoft Office Suite and claims management systems
• Excellent written, verbal, and presentation skills
• Ability to manage multiple priorities in a fast-paced, high-volume environment
• Ability to work independently while collaborating effectively across departments
• Ability to pass a background check

Preferred Qualifications:

• Non-Standard Auto Insurance experience
• Prior Quality Assurance, Quality Control, or Claims Audit experience
• Supervisory or management experience
• Experience developing training materials, best practices, and process improvement initiatives
• Experience creating reports, scorecards, and performance metrics

The Quality Assurance Auditor serves as a key partner within the Claims organization, helping drive operational excellence, technical accuracy, compliance, and customer service performance. This position is responsible for conducting claim file audits, analyzing quality results, identifying trends and improvement opportunities, and partnering with leadership to develop meaningful action plans that enhance overall claim performance.

The ideal candidate combines deep technical claims knowledge with strong analytical skills and a passion for continuous improvement.

What You'll Do:

• Quality Reviews & Auditing
• Conduct detailed claim file quality audits across multiple claim disciplines.
• Evaluate claim handling for technical accuracy, compliance, documentation, customer service, and best practice adherence.
• Perform ad hoc audits based on organizational needs and emerging trends.
• Assist with calibration efforts to ensure consistency among auditors and claims leadership.
• Analysis & Reporting
• Analyze audit results and identify trends, root causes, and areas for improvement.
• Measure compliance with company standards, carrier guidelines, and regulatory requirements.
• Quantify impacts of non-compliance and recommend corrective actions.
• Develop reports, scorecards, presentations, and performance summaries for leadership.
• Process Improvement & Best Practices
• Assist in developing and maintaining claims procedures, workflows, and best practice guidelines.
• Support initiatives focused on improving claim quality, customer satisfaction, loss control, and operational efficiency.
• Identify system enhancement opportunities and partner with IT teams on process improvements.
• Participate in testing claims systems, procedures, reports, and technology enhancements.
• Training & Collaboration
• Provide coaching and training support to claims professionals regarding audit findings and technical claim handling.
• Share best practices through written reports, presentations, and team meetings.
• Partner with claims leadership to develop action plans and monitor performance improvement initiatives.
• Collaborate with multiple business partners across the organization.
• Compliance & Governance
• Ensure adherence to state and federal regulations, Department of Insurance requirements, carrier guidelines, and company standards.
• Remain current on insurance regulations and compliance requirements across multiple jurisdictions.
• Support Aspire's digital transformation and innovation initiatives through data-driven recommendations.

What You'll Bring:

• Strong technical claims expertise
• Exceptional analytical and problem-solving skills
• Ability to identify trends and recommend meaningful solutions
• Excellent presentation and communication abilities
• Strong organizational and project management skills
• Ability to influence and collaborate across all levels of the organization
• Detail-oriented approach with a focus on quality and compliance
• Self-motivated mindset with the ability to work independently

Working Conditions:

• Fast-paced and highly collaborative work environment
• Paperless, technology-driven workplace
• Extended periods of computer use and sitting
• Occasional travel may be required
• Ability to manage multiple priorities and deadlines while maintaining accuracy