Claims Auditor - Homeowners

Job Description

Claims Auditor

Job Summary

Seeking a detail-oriented and experienced Claims Auditor to join a team. As a Claims Auditor, you will play a critical role in ensuring compliance with company guidelines, regulatory requirements, and industry best practices. You will evaluate the quality, accuracy, and timeliness of claim handling, identify areas for improvement, and contribute to the enhancement of operational effectiveness. This is an exciting opportunity to join a growing team and make a meaningful impact.

Compensation Package

• Salary Range: $65,000 - $90,000 per year (commensurate with experience)
• Discretionary Annual Bonus
• Comprehensive benefits package, including health, dental, and vision insurance, and more.
  
  

Responsibilities

• Conduct audits of claim files to ensure compliance with internal policies, state regulations, and industry standards.
• Evaluate coverage analysis, investigations, documentation, reserving, and settlement activities for accuracy and completeness.
• Identify procedural gaps, compliance risks, and opportunities for operational improvement.
• Prepare detailed audit reports and communicate findings to claims leadership.
• Analyze audit trends to support performance improvement initiatives and recommend corrective actions.
• Participate in internal and external audit activities, including Department of Insurance (DOI) and reinsurer reviews.
• Maintain accurate audit documentation and ensure adherence to retention requirements.
• Support audit planning, scheduling, file selection, and quality monitoring.
• Contribute to training and continuous improvement efforts based on audit outcomes.
  
  

Qualifications/Requirements

• Education: Bachelor’s degree in business, insurance, risk management, or a related field preferred.
• Experience:
• Minimum of 5 years of experience in property and casualty (P&C) claims handling, quality assurance, or claims auditing.
• Familiarity with property and liability claims, including CAT work, is preferred.
• Technical Skills:
• Strong knowledge of policy interpretation, coverage analysis, and claims best practices.
• Proficiency with claims management systems such as Guidewire and Xactimate.
• Proficiency with Microsoft 365 (Teams, Word, Excel, PowerPoint, Outlook).
• Competencies:
• Strong analytical skills to evaluate complex files and identify trends and risks.
• Excellent communication skills with the ability to present findings clearly and professionally.
• High level of integrity, confidentiality, and adherence to audit and regulatory standards.
• Commitment to continuous professional development and quality improvement.