Summary:

The Claims Auditor is responsible for conducting regular audits of multi-line commercial claim files to evaluate claim quality. This role partners with Claims Leadership to provide constructive feedback, identify training opportunities, and support the ongoing development of claims staff while promoting consistent claims handling practices across the department.

Essential Duties and Responsibilities

• Conduct monthly claim file audits for assigned Claims Examiners and Adjusters.
• Evaluate claim files for technical accuracy, compliance, documentation, investigation quality, coverage analysis, liability decisions, litigation management, and overall claim handling.
• Provide timely, constructive feedback to adjusters and management regarding audit results.
• Identify trends and opportunities for coaching, training, and process improvement.
• Partner with Claims Leadership to improve department quality and consistency.
• Assist with onboarding, mentoring, and development of claims staff as needed.
• Prepare quarterly audit summaries and performance reports for managers.
• Maintain confidentiality of claim information and audit findings.
• Perform other related duties as assigned.

Required Education & Experience

• Bachelor's degree or equivalent claims experience.
• 8-10 years of successful General Liability claims handling experience is required.
• Experience handling litigated General Liability claims from investigation through resolution.
• Strong understanding of coverage analysis, liability investigations, negotiations, litigation management, and claim documentation.
• Construction Defect, Commercial Auto, Property, or Garage experience is a plus.
• Prior leadership, mentoring, training, or quality assurance experience is preferred but not required.
• North Carolina Adjuster's License preferred.

Required Skills

• Excellent investigative and analytical skills.
• Ability to objectively evaluate claim quality and provide constructive coaching.
• Excellent written and verbal communication skills.
• Strong organizational and time management skills.
• Proficient with Microsoft Word and Excel.
• Ability to quickly learn and utilize claims handling and auditing systems.
• Ability to identify trends, recommend improvements, and collaborate with leadership to enhance claim quality.
• Strong interpersonal skills with the ability to mentor and develop others.

Preferred Qualifications

• Previous auditing, quality assurance, or training experience.
• Experience mentoring or coaching claims professionals.
• Claims experience including General Liability, Construction Defect, Commercial Auto, Property, or Garage.

Mental Requirements:

The position requires using and interpreting information and facts that may require refining and improving existing methods of analysis. The incumbent has considerable latitude for decision making and establishment of priorities. Significant planning is required to coordinate with other organizational units.

PHYSICAL REQUIREMENTS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to use hands to finger, handle controls and talk or hear. The employee frequently is required to sit and reach with hands and arms. The employee is occasionally required to stand and walk. The employee may occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, color vision, and the ability to adjust focus.

WORK ENVIRONMENT:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The noise level in the work environment is usually moderate. Works primarily indoors.

TRAVEL: 5%