Claims Quality Assurance Analyst

Reserv is an insurtech creating and incubating cutting-edge AI and automation technology to bring efficiency and simplicity to claims. Founded by insurtech veterans with deep experience in SaaS and digital claims, Reserv is venture-backed by Bain Capital and Altai Ventures and began operations in May 2022. We are focused on automating highly manual tasks to tackle long-standing problems in claims and set a new standard for TPAs, insurance technology providers, and adjusters alike.

We have ambitious (but attainable!) goals and need people who can work in an evolving environment. If building a leading TPA and the prospect of tackling the long-standing challenges of the claims role sounds exciting, we can’t wait to meet you.

As a Quality Assurance Analyst, you will be responsible for ensuring the quality of claims processing through the implementation and management of quality assurance processes and procedures. You will analyze claims data and identify emerging patterns and gaps in existing processes to improve the overall claims process. A Reserv QA Analyst is someone who understands that the QA process isn’t meant to be punitive, but rather is an opportunity for development and process improvement.

This position requires someone who is detail-oriented, analytical, and operationally-minded to ensure that the company delivers the highest level of quality and service to its clients.

• Highly motivated and growth-oriented. You're excited by the prospect of building a tech-driven claims org.
• Passionate QA professional who cares about the customer and their experience.
• Empathetic. You exercise empathy and patience towards everyone you interact with.
• Sense of urgency - at all times. That does not mean working at all hours.
• Creative. You challenge existing assumptions and find ways of leveraging technology to reimagine the QA process.
• Curious. You want to know the whole story so you can make the right decisions early an be decisive when it counts.
• Anti-status quo. You don’t just wish things were done differently, you action on it.
• Communicative. (we'd love to know what this means to you)
• And did we mention, a sense of humor. Claims are hard enough as it is.

We need you to do all the things typical to the role:

• Conduct audits and reviews of claims to ensure compliance with industry regulations, company policies, and procedures, verifying that payments were made correctly and in accordance with appropriate plans and policies
• Analyze claims data to identify trends, patterns, and opportunities for improvement
• Develop and implement quality assurance processes and procedures to improve the overall claims process
• Maintain relationships our clients' audit teams, providing support when claims functions are being audited and managing action points
• Create reports and analysis on claims quality, including trends, patterns, and opportunities for improvement; communicate findings to Claims stakeholders and identify opportunities to increase use of data in identifying trends
• Identify and analyze potential risks and fraud within the claims process
• Assist with developing training materials, documentation, quick reference guides and help to facilitate training sessions with the claims team
• Stay up-to-date on industry trends, regulations, and best practices related to claims quality assurance
• Participate in both internal and external audits as needed

Requirements

• Bachelor's degree (lack of one should not stop you from applying if you possess all the other qualifications)
• 8+ years of experience in claims quality assurance or related field, preferred you have prior claim adjuster handling experience
• Experience with claims and unfair practices act statutory compliance preferred
• Strong analytical skills and attention to detail
• Ability to work independently and as part of a team in a fast-paced environment
• Strong familiarity with industry best practices, but an equally strong comfort in thinking critically about easier, even better ways of working
• Experience with data analytics tools
• Experience in the insurance industry preferred

Benefits

• Generous health-insurance package with nationwide coverage, vision, & dental
• 401(k) retirement plan with employer matching
• Competitive PTO policy – we want our employees fresh, healthy, happy, and energized!
• Generous family leave policy
• Work from anywhere to facilitate your work life balance paired with frequent, regular corporate retreats to build team cohesion, reinforce culture, and have fun
• Apple laptop, large second monitor, and other quality-of-life equipment you may want. Technology is something that should make your life easier, not harder!

At Reserv, we value diversity and believe that a variety of perspectives leads to innovation and success. We are actively seeking candidates who will bring unique perspectives and experiences to our team. We welcome applicants from all backgrounds and encourage those from underrepresented groups to apply. If you believe you are a good fit for this role, we would love to hear from you!

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