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Frontline Insurance Managers Inc. • Lake Mary, Florida, United States
Role & seniority: Claims Quality Assurance Specialist (mid-level)
Stack/tools: Claims management software; Microsoft Office; data analytics tools (nice to have)
Perform comprehensive audits of claims files for accuracy, completeness, and regulatory compliance
Identify trends/root causes of errors; recommend corrective actions to management
Provide feedback, coaching, and training to claims teams; develop QA documentation and performance metrics
Bachelor’s degree in Business, Insurance, Risk Management, or related field
≥3 years in claims processing, quality assurance, or related insurance function
Knowledge of insurance claims procedures, regulations, and compliance standards
Proficiency with claims management software and Microsoft Office
Strong analytical, organizational, and communication skills
AIC or CPCU certifications
Experience with data analytics tools
Familiarity with US regulatory requirements
Demonstrated QA project leadership
Remote or hybrid work experience
Location & work type: Not specified; remote or hybrid work options likely available
At Frontline Insurance, we are on a mission to Make Things Better, and our employees play a pivotal role in achieving this vision. We strive to provide high quality service and proactive solutions to all our customers to ensure that we are making things better for each one.
What makes us different? At Frontline Insurance, our core values – Integrity, Patriotism, Family, and Creativity – are at the heart of everything we do. We’re committed to making a difference and achieving remarkable things together. If you’re looking for a role where you can make a meaningful impact and grow your career, your next adventure starts here! Learn more about Frontline Insurance here [https://www.frontlineinsurance.com/our-story].
The Claims Quality Assurance Specialist plays a critical role in ensuring the accuracy, compliance, and efficiency of the claims processing function within the organization. This position is responsible for conducting detailed audits and reviews of claims to identify errors, inconsistencies, and opportunities for process improvement. The specialist collaborates closely with claims adjusters, underwriters, and other stakeholders to provide actionable feedback and support training initiatives that enhance overall claims quality. By maintaining rigorous quality standards, this role helps to minimize financial risk and improve customer satisfaction. Ultimately, the Claims Quality Assurance Specialist contributes to the integrity and reliability of the claims operation, supporting the organization's commitment to excellence and regulatory compliance.
The Claims Quality Assurance Specialist utilizes analytical skills daily to review and interpret claims data, identifying discrepancies and areas for improvement. Strong communication skills are essential for providing clear, constructive feedback to claims teams and collaborating with various departments to implement quality initiatives. Proficiency with claims management software and data analysis tools enables the specialist to efficiently conduct audits and generate detailed reports that inform decision-making. Organizational skills are critical for managing multiple audits simultaneously while maintaining accuracy and meeting deadlines. Additionally, knowledge of regulatory standards ensures that all claims processes comply with legal requirements, reducing risk and enhancing the organization's reputation.