Director, Claims Audit
Coaction Global, Morristown, TN, United States
At Coaction, we’re a unique mix of leaders, achievers, thinkers, and team players with a high‑performance mindset and a diverse skillset. We bring our industry expertise together to continually push the boundaries of what insurance can be for our clients.
Key Responsibilities Quality Review
Working with the AVP of the Claim Excellence team, lead, manage, and coordinate all claim quality, focused and targeted reviews across units.
Ensure the enhanced claim review questionnaire is used consistently, including root‑cause analysis and leakage evaluation and claim handling aligns with company protocols.
Oversee quality control and action plans of claim review outputs.
Produce results and trend reports for leadership review.
Calibration & Consistency
Facilitate claim management calibration reviews and maintain calibration scoring.
Ensure consistent application of standards across all claim lines.
Partner with leadership to maintain alignment.
Action Planning & Performance
Translate claim department claim review results into actionable improvement plans.
Track and validate action‑plan outcomes tied to performance goals.
Monitor progress across all claim units and escalate risks.
Training & Development Integration
Partner with learning and development teams to design and deliver curriculum based on claim review findings.
Support coaching, training and skill‑building for claim examiners and leaders.
Maintain feedback loops to evaluate training effectiveness.
Compliance Oversight
Ensure claims meet internal claim handling protocols and regulatory requirements.
Maintain documentation, testing, and claim review trails for compliance reviews.
Support preparation for regulatory exams and market conduct reviews.
Leadership & Collaboration
Provide day‑to‑day direction to claim departments.
Serve as subject‑matter expert for quality, compliance, and training integration.
Support strategic objectives as defined by the AVP of Claim Excellence.
Qualifications
7–10+ years of claim leadership experience in property/casualty or professional liability.
Deep technical knowledge of claims and claim regulatory compliance.
Experience in quality audit, claim training, or process improvement.
Strong analytical and communication skills.
Ability to lead cross‑functional initiatives and influence without authority.
Success Measures
Reduction in claim leakage and improved accuracy of claim handling.
Consistent audit completion and calibration scores across units.
Measurable improvements in claim examiner/supervisor capability.
Stronger compliance readiness and fewer regulatory findings.
Timely execution and completion of action plans.
This is not a fully remote position. Applicants must sit in our Morristown, NJ office on our hybrid work schedule.
Salary range specific to this role: $99,000‑$133,000 + discretionary incentive bonus + benefits depends on various factors including, without limitation, individual and organizational performance. The offered rate of compensation will be based on individual education, experience, and qualifications. In addition, employees are eligible for standard benefits package including paid time off, medical, dental and retirement.
Equal Opportunity Employer Coaction is an Equal Employment Opportunity employer. Coaction’s policy is not to discriminate against any applicant or employee based on race, color, religion, national origin, gender, age, sexual orientation, gender identity or expression, marital status, mental or physical disability or genetic information, or any other basis protected by applicable law. Coaction also prohibits harassment of applicants or employees based on any of these protected categories.
If your application is selected, you will receive an email directly from the Coaction Recruiting Team at coaction@myworkday.com asking you to contact a member of the Coaction Recruiting Team. Any other method of contact may be fraudulent.
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Key Responsibilities Quality Review
Working with the AVP of the Claim Excellence team, lead, manage, and coordinate all claim quality, focused and targeted reviews across units.
Ensure the enhanced claim review questionnaire is used consistently, including root‑cause analysis and leakage evaluation and claim handling aligns with company protocols.
Oversee quality control and action plans of claim review outputs.
Produce results and trend reports for leadership review.
Calibration & Consistency
Facilitate claim management calibration reviews and maintain calibration scoring.
Ensure consistent application of standards across all claim lines.
Partner with leadership to maintain alignment.
Action Planning & Performance
Translate claim department claim review results into actionable improvement plans.
Track and validate action‑plan outcomes tied to performance goals.
Monitor progress across all claim units and escalate risks.
Training & Development Integration
Partner with learning and development teams to design and deliver curriculum based on claim review findings.
Support coaching, training and skill‑building for claim examiners and leaders.
Maintain feedback loops to evaluate training effectiveness.
Compliance Oversight
Ensure claims meet internal claim handling protocols and regulatory requirements.
Maintain documentation, testing, and claim review trails for compliance reviews.
Support preparation for regulatory exams and market conduct reviews.
Leadership & Collaboration
Provide day‑to‑day direction to claim departments.
Serve as subject‑matter expert for quality, compliance, and training integration.
Support strategic objectives as defined by the AVP of Claim Excellence.
Qualifications
7–10+ years of claim leadership experience in property/casualty or professional liability.
Deep technical knowledge of claims and claim regulatory compliance.
Experience in quality audit, claim training, or process improvement.
Strong analytical and communication skills.
Ability to lead cross‑functional initiatives and influence without authority.
Success Measures
Reduction in claim leakage and improved accuracy of claim handling.
Consistent audit completion and calibration scores across units.
Measurable improvements in claim examiner/supervisor capability.
Stronger compliance readiness and fewer regulatory findings.
Timely execution and completion of action plans.
This is not a fully remote position. Applicants must sit in our Morristown, NJ office on our hybrid work schedule.
Salary range specific to this role: $99,000‑$133,000 + discretionary incentive bonus + benefits depends on various factors including, without limitation, individual and organizational performance. The offered rate of compensation will be based on individual education, experience, and qualifications. In addition, employees are eligible for standard benefits package including paid time off, medical, dental and retirement.
Equal Opportunity Employer Coaction is an Equal Employment Opportunity employer. Coaction’s policy is not to discriminate against any applicant or employee based on race, color, religion, national origin, gender, age, sexual orientation, gender identity or expression, marital status, mental or physical disability or genetic information, or any other basis protected by applicable law. Coaction also prohibits harassment of applicants or employees based on any of these protected categories.
If your application is selected, you will receive an email directly from the Coaction Recruiting Team at coaction@myworkday.com asking you to contact a member of the Coaction Recruiting Team. Any other method of contact may be fraudulent.
#J-18808-Ljbffr