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Qa Claims Jobs (NOW HIRING)

Quality Assurance Partnership: Partners with the Claims Quality team to use centralized audit findings in support of team development, performance management, and operational oversight. Reviews QA ...

Quality Assurance Partnership: Partners with the Claims Quality team to use centralized audit findings in support of team development, performance management, and operational oversight. Reviews QA ...

The Claims Quality Assurance Auditor maintains positive working relationships with our internal and external customers, health plan's, providers and/or members by seeking a partnership approach that ...

Claims Quality Assurance Auditor

Whittier, CA ยท On-site

$23 - $36.70/hr

The Claims Quality Assurance Auditor maintains positive working relationships with our internal and external customers, health plan's, providers and/or members by seeking a partnership approach that ...

Quality Assurance Partnership: Partners with the Claims Quality team to use centralized audit findings in support of team development, performance management, and operational oversight. Reviews QA ...

Quality Assurance Partnership: Partners with the Claims Quality team to use centralized audit findings in support of team development, performance management, and operational oversight. Reviews QA ...

Quality Assurance Partnership: Partners with the Claims Quality team to use centralized audit findings in support of team development, performance management, and operational oversight. Reviews QA ...

Quality Assurance Partnership: Partners with the Claims Quality team to use centralized audit findings in support of team development, performance management, and operational oversight. Reviews QA ...

Quality Assurance Partnership: Partners with the Claims Quality team to use centralized audit findings in support of team development, performance management, and operational oversight. Reviews QA ...

Quality Assurance Partnership: Partners with the Claims Quality team to use centralized audit findings in support of team development, performance management, and operational oversight. Reviews QA ...

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Qa Claims information

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$29

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How much do qa claims jobs pay per hour?

As of Sep 9, 2026, the average hourly pay for qa claims in the United States is $29.40, according to ZipRecruiter salary data. Most workers in this role earn between $22.36 and $35.10 per hour, depending on experience, location, and employer.

What is a QA Claims?

A QA Claims job involves reviewing and analyzing insurance claims to ensure accuracy, compliance, and adherence to company policies and industry regulations. Professionals in this role identify errors, inconsistencies, or potential fraud while providing feedback for process improvements. They work closely with claims adjusters and management to enhance efficiency and maintain quality standards. Strong attention to detail, analytical skills, and knowledge of insurance guidelines are essential for success in this role.

What does a QA Claims do?

A QA Claims role involves reviewing claims files for accuracy, completeness, and compliance with company policies and regulations, often requiring careful analysis and documentation. You may be tasked with identifying trends, proposing process improvements, and providing feedback or training to claims adjusters to enhance quality standards. One common challenge is balancing the high volume of claims with the need for thorough quality checks, especially during peak periods. These professionals often collaborate closely with claims teams, auditors, and compliance staff to resolve complex cases and streamline workflows, making attention to detail and strong communication essential for success.

What are the key skills and qualifications needed to thrive in a QA Claims position?

To thrive as a QA Claims professional, you need a strong understanding of insurance claims processes, quality assurance methodologies, and attention to detail, often supported by industry certifications such as CPCU or AIC. Familiarity with claims management systems, data analysis tools, and workflow tracking software is typically required. Excellent analytical thinking, effective communication, and problem-solving skills help you excel in identifying discrepancies and collaborating with adjusters or other departments. These abilities are vital for ensuring claim accuracy, regulatory compliance, and continuous process improvement within an insurance organization.

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What states have the most Qa Claims jobs?

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Infographic showing various Qa Claims job openings in the United States as of September 2026, with employment types broken down into 1% Internship, 88% Full Time, 9% Part Time, and 2% Contract. Highlights an 82% Physical, 4% Hybrid, and 14% Remote job distribution, with an average salary of $61,156 per year, or $29.4 per hour.

AVP, Claims Quality Assurance & Performance Management

Omaha, NE โ€ข On-site

$150 - $200/hr

Other

Medical, Dental, Vision, Retirement, PTO

Posted 7 days ago


Key responsibilities

  • Lead the reestablishment, design, and implementation of Argo's claims QA program.

  • Evaluate claim handling quality, including coverage, reserving, documentation, and claim strategy, and develop feedback for claims handlers and leadership.

  • Build reporting and analytics to evaluate claim quality, operational effectiveness, and KPI performance, and deliver executive-level reports.


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 Argoโ€™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 Argoโ€™s QA program with other Clearbrook entities while positioning Argo as the leading example of data-driven claims QA. The roleโ€™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 Argoโ€™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 Argoโ€™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: Bachelorโ€™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 customersโ€™ 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 be commensurate with 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 programโ€”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 aspire to be - guiding how we work, how we lead and how we succeed. Argo and Farm Family are specialty property and casualty insurance brands whose underwriting companies are wholly owned subsidiaries of Clearbrook Group Holdings Inc. Argo and Farm Family partner with agents and brokers to provide insurance solutions that enable businesses to manage risks with confidence. At Clearbrook our Core Values are Integrity, Collaboration, Pursuit of Excellence and Forward Thinking. These values reflect who we are today and who we aspire to be - guiding how we work, how we lead and how we succeed.

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