Claim Quality Audit Specialist

Great American Insurance Group
13 Jan 2019
19 Jan 2019
Job role
Contract type
Full time

Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group's member companies are subsidiaries of American Financial Group, a Fortune 500 company. We combine a "small company" culture where your ideas will be heard with "big company" expertise to help you succeed. With over 30 specialty property and casualty operations and a variety of financial services, there are always opportunities here to learn and grow.

Great American's Public Sector Division offers a comprehensive list of coverages in the reinsurance and excess insurance markets primarily for pools, trusts, joint powers authorities and captives in the public entity space. Targeted classes include schools, municipalities, counties, housing authorities and other special service districts with minimum self–insured retentions of $100,000.

The Public Sector Division is currently searching for a Claim Quality Audit Specialist. The person hired for this position will work from our downtown Cincinnati, Ohio corporate offices or, if not in the Cincinnati metro area, Glen Allen, VA, or from home. Willingness to travel up to 50% of the time, including overnight travel, is required.


* Manages the Public Sector Claim Audit Process to review and analyze the claims handling of third party administrators and pool claim organizations.
* Evaluates claim loss run reports to plan and complete the audit process.
* Organizes the public sector group audit schedule.
* Completes on–line claim audits of third party administrators and claim organizations either through on–line review the claim system or in–person review of the claim files.
* Meets with third party administrators, pool administrators, and public sector claims and underwriting staff to review and discuss audit findings and recommendations.
* Completes written claim review reports for distribution.
* Measures performance opportunities through use of file / re–inspection process, calibration process and / or audit process.
* Interacts with various levels of claims management to communicate audit findings and recommend solutions for continuous process improvement.
* May review and respond to regulatory inquiries and litigated matters.
* Performs other duties as assigned.


* 6 or more years of related experience, including Audit experience.
* Strong customer service skills are essential to this position.
* Highly effective communicator; both verbally and in writing. Able to communicate effectively with people at all levels from across the organization and with external contacts.
* Must be skilled at establishing and adjusting priorities as needed.
* Strong time management skills and the ability to multi–task in a fast–paced environment.
* Intermediate to advanced skills with MS Office, including Word, Excel and Outlook, as well as the ability to learn proprietary software.
* Bachelor's Degree or equivalent experience.
* Progression toward professional certification or designation preferred; potential appropriate certifications/designations could include AIC (Associate in Claims Program) or CPCU (Chartered Property Casualty Underwriter).