Claims Quality Audit Analyst

CoAction

$69K — $107K *
Finance & Insurance
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • 4+ years of claim leadership experience in property/casualty or professional liability.
  • Deep technical knowledge of claims and claim regulatory compliance.
  • Experience in quality audit, claim training, or process improvement.
  • Strong analytical and communication skills.
  • Ability to lead cross-functional initiatives and influence without authority.

Responsibilities

  • Lead and coordinate claim quality reviews across business units.
  • Ensure consistent use of enhanced claim review questionnaires.
  • Oversee quality control and action plans from claim review outputs.
  • Produce trend reports for leadership review.
  • Facilitate calibration reviews and maintain scoring across departments.
  • Translate claim review results into actionable improvement plans.
  • Partner with learning teams to design curriculum based on review findings.

Benefits

  • Standard benefits package including paid time off, medical, dental, and retirement.
  • Hybrid work schedule with required in-office presence in Morristown, NJ.
Full Job Description

The Claim Quality Audit Analyst, is responsible for overseeing claim quality reviews, calibration of manager reviews, compliance monitoring, and training initiatives to ensure consistent, accurate, and highquality claim handling across all claim business units. The Claims Analyst partners closely with claim leadership to identify gaps, implement action plans, and drive continuous improvement.

Key Responsibilities:

Quality Review

  • Working with the AVP of the Claim Excellence team, lead, manage, and coordinate all claim quality, focused and targeted reviews across units.

  • Ensure the enhanced claim review questionnaire is used consistently, including rootcause analysis and leakage evaluation and claim handling aligns with company protocols.

  • Oversee quality control and action plans of claim review outputs.

  • Produce results and trend reports for leadership review.

Calibration & Consistency

  • Facilitate claim management calibration reviews and maintain calibration scoring.

  • Ensure consistent application of standards across all claim lines.

  • Partner with leadership to maintain alignment.

Action Planning & Performance

  • Translate claim department claim review results into actionable improvement plans.

  • Track and validate actionplan outcomes tied to performance goals.

  • Monitor progress across all claim units and escalate risks.

Training & Development Integration

  • Partner with learning and development teams to design and deliver curriculum based on claim review findings.

  • Support coaching, training and skillbuilding for claim examiners and leaders.

  • Maintain feedback loops to evaluate training effectiveness.

Compliance Oversight

  • Ensure claims meet internal claim handling protocols and regulatory requirements.

  • Maintain documentation, testing, and claim review trails for compliance reviews.

  • Support preparation for regulatory exams and market conduct reviews.

Leadership & Collaboration

  • Provide daytoday direction to claim departments

  • Serve as subjectmatter expert for quality, compliance, and training integration.

  • Support strategic objectives as defined by the AVP of Claim Excellence.

Qualifications

  • 4+ years of claim leadership experience in property/casualty or professional liability.

  • Deep technical knowledge of claims and claim regulatory compliance.

  • Experience in quality audit, claim training, or process improvement.

  • Strong analytical and communication skills.

  • Ability to lead crossfunctional initiatives and influence without authority.

Success Measures

  • Reduction in claim leakage and improved accuracy of claim handling.

  • Consistent audit completion and calibration scores across units.

  • Measurable improvements in claim examiner/supervisor capability.

  • Stronger compliance readiness and fewer regulatory findings.

  • Timely execution and completion of action plans.

**This is not a fully remote position. Applicants must sit in our Morristown, NJ office on our hybrid work schedule.**

Salary range specific to for this role : $69,000-$107,000 + discretionary incentive bonus + benefits depends on various factors including, without limitation, individual and organizational performance. The offered rate of compensation will be based on individual education, experience, and qualifications. In addition, employees are eligible for standard benefits package including paid time off, medical, dental and retirement.

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