Quality Reviewer II

Reviews property and/or casualty claims to ensure quality and compliance with client instructions and service level agreements.

Investigates and analyzes quality trends, recommends solutions and ensures corrections are made.


* Bachelors degree or equivalent combination of education and experience.


* Five years of experience handling complex property and/or casualty claims and Xactimate experience.


* Audit/quality control experience


* Experience in automated testing of environment is strongly preferred


* Excellent writing and verbal communication skills


* Strong analytical ability


* Attention to detail.


* Ability to work independently in a multi-tasking environment with a sense of urgency


* Must possess critical thinking, interpersonal, problem solving, teamwork, and organizational skills.


* Must have or secure and maintain the appropriate license(s) as required by the state(s) at the adjuster level.


* Must complete continuing education requirements as outlined by Crawford Educational Services

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* Responsible for the review, testing and analysis of complex claim files to ensure quality work products are sent to clients.


* Manages the tracking, reporting and analysis of quality data.

Makes decisions regarding the depth of testing required based various criteria including: adjuster, client, and previous/common errors.


* Partners across departments and with other claims technical staff to ensure overall product quality.


* Reviews and verifies information regarding complex claims to ensure the proper processing in accordance with established quality standards.


* Reads and interprets complicated customer and vendor specifications.


* Develops and assesses alternative methods to achieve uniform quality including identifying process variables and training opportunities.


* Verifies corrected material and prepares quality assurance reports as appropriate.


* Analyzes claims and process trends and makes corrective recommendations.


* Continuously monitors performance and reports performance issues to appropriate management to coordinate the corrective action process.


* Identifies best practices and applies these to meet efficiency and cost objectives and ensure measurements are applied to demonstrate results.


* Assist in the training of other QA staff through formal classes when new processes are introduced to help ensure consistency throughout the department.


* Upholds the Crawford Code of Conduct.