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RYZE Claim Solutions

INTERNAL CANDIDATES ONLY- QA Specialist

Posted 21 minutes ago
5-10 years experience
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AI Summary

The QA Specialist manages a network of independent reviewers by sourcing, onboarding, and auditing their work to ensure quality standards are met. They also act as the primary point of contact for client escalations and define the rules for automated quality assurance tools.

About the Role

The QA Specialist leads the quality review work instead of doing every review. You will source, onboard, support, and audit a network of independent (1099) reviewers, define the rules our QAi tool checks on each claim, and act as the account expert and client escalation point. You use your own judgment to set the quality standard, decide whether work meets it, and decide how files are assigned.

You complete reviews yourself only after the leading work is done, and none during busy periods.



What You'll Do

  • Build the reviewer network: source and vet independent (1099) reviewers, working with leadership and recruiting, including confirming licensing and qualifications.
  • Onboard: create and maintain onboarding materials on carrier guidelines, account requirements, and our quality standards for independent reviewers.
  • Be the point of contact: answer independent reviewer questions on carrier guidelines and account requirements so files keep moving.
  • Audit and evaluate: audit completed 1099 work product against quality standards, give feedback on deliverables, and use quality and turnaround data to decide how files are assigned, including offering more files or ending an engagement.
  • Assign files: offer and assign files across the independent reviewer network so carrier deadlines are met, including in busy periods.
  • Set the QAi rules: define the rules QAi checks on each claim. You work with IT, who build and configure the tool.
  • Own your accounts: be the knowledge expert for the accounts you handle, including carrier guidelines, authority limits, and preferred systems.
  • Handle escalations: be the escalation point for files for the client, taking the load off field leaders and account executives.
  • Work the file: update the estimate based on the carrier rules and the photos provided, using your license in that state and the carrier's preferred system, such as Xactimate.
  • Review last: complete reviews when everything else is done. In busy periods, none. In slow periods or on tight timelines, you may review.
  • Measure the work: track process and time to complete tasks. This role manages quality and cycle time, not cost.

 

Availability

  • You are available during core business hours and peak periods, so reviewer questions and client escalations get answered while files are moving.



What We're Looking For

Required:

  • Strong quality judgment on residential property claims.
  • Working knowledge of carrier guidelines and account requirements.
  • Estimating skill in Xactimate or the carrier's preferred system, and an active adjuster license.
  • Comfort auditing work product and giving quality feedback to independent reviewers.
  • Ability to use data to judge quality and time in process.
  • Clear communication and accountability with clients, leaders, and 1099 reviewers.
  • Interest in how rules and systems drive automation.


How success is measured

Measures for leading the independent reviewer network and QAi are being built with leadership and will be shared before the roles go live.

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