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Claims Quality Analyst Jobs (NOW HIRING)

Senior Quality Analyst (Claims)

New York, NY ยท On-site

$56K - $99K/yr

Prior extensive experience in quality and/or root cause analysis required * Prior knowledge in insurance coding and/or claims experience required * Knowledge of EmblemHealth's processes and Facets ...

New

... claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries ... Job title: Quality Analyst We are currently hiring a talented Quality Analyst to join us in a ...

... claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries ... Job title: Quality Analyst We are currently hiring a talented Quality Analyst to join us in a ...

... claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries ... Quality Analyst Education: High School Graduate is required Experience: Min 1-2 years of experience ...

... claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries ... Quality Analyst Education: High School Graduate is required Experience: Min 1-2 years of experience ...

... claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries ... Quality Analyst Education: High School Graduate is required Experience: Min 1-2 years of experience ...

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Claims Quality Analyst information

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$27

$51

How much do claims quality analyst jobs pay per hour?

As of Aug 16, 2026, the average hourly pay for claims quality analyst in the United States is $27.39, according to ZipRecruiter salary data. Most workers in this role earn between $20.19 and $31.49 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a claims quality analyst?

To thrive as a Claims Quality Analyst, you need a strong understanding of insurance claims processes, attention to detail, and experience with quality assurance methodologies, often supported by a relevant degree or claims certification. Familiarity with claims management systems, auditing software, and data analysis tools like Excel or SQL is typically required. Excellent analytical thinking, communication, and problem-solving skills help you identify errors and communicate findings effectively. These abilities are crucial for ensuring accuracy, compliance, and process improvements in claims handling.

What is a claims quality analyst?

A Claims Quality Analyst is a professional who reviews and evaluates insurance claims processes to ensure accuracy, compliance, and efficiency. They analyze claim files, audit claim decisions, and identify trends or errors to help improve the overall quality of claims handling. Their role is crucial in maintaining high standards, reducing errors, and ensuring that claims are processed in accordance with company policies and regulatory requirements.

What is the difference between Claims Quality Analyst vs Claims Examiner?

AspectClaims Quality AnalystClaims Examiner
Primary RoleReviews and audits claims to ensure accuracy and compliance with policiesProcesses and approves or denies insurance claims based on policy details
Required SkillsAttention to detail, knowledge of claims processes, quality assuranceAnalytical skills, knowledge of insurance policies, decision-making
Work EnvironmentOffice setting, quality assurance teamsClaims departments, insurance offices
CertificationsTypically no specific certifications required, but industry knowledge beneficialLikewise, certifications are optional but helpful (e.g., CPCU)

Claims Quality Analysts focus on reviewing claims for accuracy and compliance, ensuring quality standards are met, while Claims Examiners handle the processing and decision-making on individual claims. Both roles require knowledge of insurance policies but differ in their primary responsibilities and focus areas.

How much do claims quality analysts make in the US?

Claims quality analysts in the US typically earn between $45,000 and $70,000 annually, depending on experience, location, and employer size. Entry-level roles may start around $40,000, while experienced analysts with certifications can earn over $75,000. The role often requires attention to detail and familiarity with claims processing systems.

What are some common challenges faced by claims quality analysts, and how can these be effectively managed?

Claims Quality Analysts often encounter challenges such as balancing high-volume case reviews with the need for thoroughness, staying updated on evolving regulatory requirements, and communicating findings constructively to claims teams. Effective management involves strong organizational skills, continuous learning, and clear, empathetic communication. Building collaborative relationships with claims adjusters and participating in ongoing training sessions can help Analysts stay current and foster a culture of continuous improvement within the team.
More about Claims Quality Analyst jobs

What are the most commonly searched types of Claims Quality Analyst jobs?

The most popular types of Claims Quality Analyst jobs are:

What states have the most Claims Quality Analyst jobs?

States with the most job openings for Claims Quality Analyst jobs include:

Infographic showing various Claims Quality Analyst job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 14% Part Time, 4% Contract, and 1% Nights. Highlights an 94% Physical, 2% Hybrid, and 4% Remote job distribution, with an average salary of $56,974 per year, or $27.4 per hour.

AVP, Claims Quality Assurance & Performance Management

Brookfield

Omaha, NE โ€ข On-site

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 11 days ago


Job description

Company

Argo Group

Argo Group is an underwriter of specialty insurance products in the property and casualty market. Argo offers a full line of products and services designed to meet the unique coverage and claims-handling needs of businesses. The Argo entities are wholly-owned subsidiaries of Clearbrook Group Holdings Inc.


Job Description

Business Title(s): AVP, Claims Quality Assurance & Performance Management

Employment Type: Full-Time

FLSA Status: Exempt

Location: In-Office

Summary:

The AVP, Claims Quality Assurance & Performance Management is responsible for leading the reestablishment, design, implementation, and ongoing evolution of Argo's claims QA program. The role reports to the Clearbrook QA Lead, with a dotted-line to the Chief Claims Officer, Argo at the enterprise level. The AVP will work closely with Argo and Clearbrook senior leadership to align Argo's QA program with other Clearbrook entities while positioning Argo as the leading example of data-driven claims QA. The role's core function is claims quality assurance, including file audit methodology, claim handling evaluation, scoring, governance, feedback, and corrective action. In addition, the role will expand QA output into a broader claims performance management capability by linking QA findings to Guidewire data, KPI trends, process assessment analytics, adjuster and manager performance evaluation, and senior leadership reporting across Argo's claims organization. We are looking to fill this role in our Omaha, NE office. Alternatively, we can also fill the role in one of our offices in Albany, Chicago, Los Angeles, New York City, or Richmond (VA).

This is a 100% in-office position. Candidates must be able to work on-site at a designated company office during standard business hours.

Essential Responsibilities:

  • QA Strategy, Governance & Compliance
    • Partner with the Argo Chief Claims Officer and Clearbrook enterprise QA leadership to reestablish Argo's QA program in alignment with enterprise standards.
    • Design and implement QA audit methodology, scoring models, and sampling strategies.
    • Evaluate claim handling quality, including coverage, reserving, documentation, and claim strategy.
    • Develop structured feedback loops to claims handlers and leadership.
    • Ensure QA supports compliance, governance, and audit readiness requirements.
  • Claims Performance Intelligence & Analytics
    • Partner with leadership to define and align claims KPIs.
    • Build reporting and analytics that use QA results as the foundation for evaluating claim quality, operational effectiveness, and KPI performance.
    • Serve as a key claims performance intelligence link for senior leadership by connecting QA audit results, claims data, KPI reporting, and process assessment findings.
    • Translate audit findings into training, process improvements, performance actions, and leadership decision-making support.
    • Deliver executive-level reporting on claim quality, claim adjuster performance, operational trends, and overall Argo business performance indicators.
  • Operational Excellence, Technology & Continuous Improvement
    • Oversee Guidewire system utilization audits and data integrity assessments.
    • Identify operational inefficiencies and recommend corrective actions.
    • Lead integration of AI-enabled QA tools and automation solutions.
    • Drive continuous improvement through enhanced audit processes, technology-enabled insights, and operational effectiveness initiatives.

Qualifications / Experience Required:

  • A specialized knowledge of managing Quality Assurance programs typically achieved through:
    • Bachelor's degree required; JD, advanced degree, CPCU, AIC, SCLA, Six Sigma/Lean, PMP, Prosci, Guidewire certification, or similar insurance, claims, audit, process improvement, project management, or change management credential preferred.
    • 7 years of progressive P&C claims experience, with strong technical claim handling, coverage, reserving, litigation management, and claim strategy expertise. Prior leadership experience building, rebuilding, or materially enhancing a claims quality assurance, claim file audit, or claims performance management program
  • Must have good business acumen (i.e. understand how an insurance company works and makes money, including how this role impacts both Argo Group and our customers' ability to be profitable).
  • Demonstrated ability to translate QA findings into measurable claim quality improvements, operational changes, training priorities, and performance management actions
  • Strong understanding of claims KPIs, audit scoring models, sampling methodologies, performance analytics, and executive-level claims reporting
  • Significant experience with Guidewire ClaimsCenter, including system utilization, data integrity, claim documentation standards, and reporting requirements
  • Proven ability to use data-driven insights to evaluate claim adjuster performance and identify broader claim operational and business performance trends
  • Experience developing structured feedback loops to LOB leaders, claims management, and claim handlers to ensure QA findings result in timely corrective action and sustained improvement
  • Experience developing and presenting training materials based on QA audit results, claim handling trends, system utilization gaps, and identified performance opportunities
  • Experience partnering with senior claims leadership, LOB leaders, business leaders, compliance, operations, IT/data teams, and training resources to implement enterprise-wide improvements
  • Strong change management skills, including the ability to reestablish governance, drive adoption, influence stakeholders, and improve consistency across claim teams
  • Excellent written and verbal communication skills, including the ability to prepare clear executive summaries, dashboards, findings reports, and leadership presentations,
  • A strong focus on execution in getting things done right. Proven ability to consistently produce and deliver expected results to all stakeholders by:
    • Finding a way to achieve success through adversity.
    • Being solution (not problem) focused
    • Thinking with a global mindset first.
  • Successful traits (flexibility, ability to thrive in change, being resourceful on your own) necessary to work in a fast paced environment that is evolving constantly.
  • Must work independently and demonstrate the ability to exercise sound judgment.
  • Exhibit natural and intellectual curiosity. Consistently considers all options and is not governed by conventional thinking.
  • Proficient in MS Office Suite and other business-related software.
  • The ability to read and write English fluently is required.
  • Must demonstrate a desire for continued professional development through continuing education and self-development opportunities.

The base salary range provided below is for hires in those geographic areas only and will becommensuratewith candidate experience. Pay ranges for candidates in other locations may differ based on the cost of labor in that location. In addition to base salary, all employees are eligible for an annual bonus based on company and individual performance as well as a generous benefits package.

  • Richmond Pay Range: $137,496 - $189,516
  • Albany and Chicago Pay Range: $151,062 - $208,386
  • Los Angeles and New York City Pay Range: $165,036 - $227,562

About Working in Claims at Argo Group

Argo Group does not treat our claims or our claims professionals as a commodity. The work we offer is challenging, diverse, and impactful.

Our Adjusters and Managers are empowered to exercise their independent discretion and, within broad limits and authority, be creative in developing solutions and treat each case as the unique situation it is.

We have a very flat organizational structure, enabling our employees have more interaction with our senior management team, especially when it relates to reviewing large losses.

Our entire claims team works in a collaborative nature to expeditiously resolve claims. We offer a work environment that inspires innovation and is open to employee suggestions. We even offer rewards for creative and innovative ideas.

We believe in building an inclusive and diverse team, and we strive to make our office a welcoming space for everyone. We encourage talented people from all backgrounds to apply.


PLEASE NOTE:

Applicants must be legally authorized to work in the United States. At this time, we are not able to sponsor or assume sponsorship of employment visas.


If you have a disability under the Americans with Disabilities Act or similar state or local law and you wish to discuss potential reasonable accommodations related to applying for employment with us, please contact our Benefits Department at 210-321-8400.


Benefits and Compensation

We offer a competitive compensation package, performance-based incentives, and a comprehensive benefits program-including health, dental, vision, 401(k) with company match, paid time off, and professional development opportunities.


Core Values

At Clearbrook our Core Values are Integrity, Collaboration, Pursuit of Excellence and Forward Thinking. These values reflect who we are today and who we apsire to be - guiding how we work, how we lead and how we succeed.