UPC Insurance

  • Claims Quality Assurance Analyst

    Job Locations US-FL-St. Petersburg
  • Overview

    Summary: This position is based in St. Petersburg FL.  The Claims Quality Auditor Analyst position is responsible to participate in the planning and conducting of independent audits of UPC Insurance claims files. The audit results will be used to evaluate compliance with UPC Claims handling guidelines and regulatory requirements, identify training opportunities and operational efficiencies, as needed.


    UPC Insurance Claims Overview: Our mission statement is to Keep the Promise® – to our policyholders, our shareholders and to our stakeholders”. The promise to our policyholders is to fairly and timely resolve their claims. Our business practices, processes, objectives and how we conduct ourselves daily is done so from the perspective of our policyholders rather than from our own convenience of how claims should be handled. This embodies the standard that our professional claims department strives to achieve every day, both in daily claims handling and CAT claims. Since the UPC mission is to be the premier provider of homeowner insurance in catastrophe exposed areas, we take our responsibility to Keep the Promise® as one of the fundamental tenets of accomplishing this mission.


    Essential Duties/Responsibilities:
    The Staff Claims Auditor is responsible for conducting independent Audits of UPC claim files in accordance with UPC Claims handling guidelines and practices. Audits are conducted electronically on a web-based platform. Audit scope includes First Party Property, CAT, Litigation and Third-Party Liability claim files. The Claims Auditor will also be responsible for generating reporting of results to assist with identification of overall performance trends and training opportunities.


    Some travel, as appropriate: approximately 10%.


    Supervisory Responsibilities: N/A


    Education and/or Experience:

    • Bachelors’ degree and a minimum five (3+) years of experience in auditing of minor to moderate claims in an insurance company environment. If no bachelors’ degree, a minimum of seven (7+) years of experience in claims auditing is required, as well as at least one of the following industry certifications: NFIP, IICRC or one or more of the following industry designations: AIC, SCLA. Prior homeowners field adjuster experience as well as proficiency in Xactimate estimating software is preferred.
    • As required by regulatory entities. Ability to acquire insurance licenses as required by role. Florida license in good standing is required within six (6) months from employment start date.

    Required Skills:

    • Ensure that all assigned claim audits are concluded equitably and promptly.
    • Excellent verbal/written communication skills and organizational skills.
    • Strong computer skills, i.e. Word, Excel, Access, Outlook and web-based programs.
    • Ability to understand the long-term and short-term perspectives of situations.
    • Ability to manage relationships in a fast-paced environment, while demonstrating persistence and problem-solving skills.
    • Emotional intelligence – self-awareness, confidence, ability to manage conflict, empathy.
    • Interpersonal and leadership skills – servant leadership, collaboration, facilitation, and negotiation skills.


    To perform the job successfully, an individual should demonstrate the following behaviors:

    • Motivation/Initiative: Motivated and curious, willing to ask questions, research issues and take on challenging projects/assignments; creative, brings new ideas to the table, exhibits self-confidence.  Has strong achievement motivation and tenacity. 
    • Administrative Skills: Possesses ability to organize and follow-through on multiple tasks, recognizes and attends to important details with accuracy and efficiency, effectively prioritizes work of staff members. Works to complete goals, tasks and plans, anticipates potential problems and analyzes alternative solutions.
    • Interpersonal Style: (Interpersonal Skills, Communication, Teamwork); develops/ maintains effective working relationships; listens attentively to others; communicates ideas clearly (written & verbal); relates to people in an open/ sincere manner; participates effectively in meetings; assists in finding solutions as well as identifying problems; communicates appropriately with supervisor, managed staff and co-workers. Able to manage other individuals and maintain calm and reliable demeanor in the face of challenges.
    • Self-Management: (Adaptability/Flexibility, Stress Tolerance, Autonomy); adapts readily to changes in routine; works effectively in stressful situations; needs limited guidance and direction; is comfortable working in a fast-paced environment; is reliable and dependable; is results-oriented; maintains productivity and composure under pressure; views problems as opportunities to create solutions.
    • Thinking Skills: Diagnoses problems efficiently; gathers sufficient input before making decision or plans; makes timely decision, quickly determines sources of problem, identifies information needed to solve problem and analyzes alternative solutions, communicates issues and decisions effectively to team. 
    • Customer Orientation: Sensitive & responsive to internal and external customer needs; demonstrates skills in customer services and satisfaction; maintains a positive attitude, willing to listen to customer problems and seeks solutions; stays in tune with changing needs of customers.

    Other Abilities/Skills:

    • Oral Communication Skills
    • Written Communication Skills
    • Customer Relations/Diplomacy
    • Customer Service
    • Organization and Time Management
    • Planning
    • Professionalism

    Physical Demands and Work Environment: While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel; and talk or hear. The employee is regularly required to stand; walk; reach with hands and arms and stoop, kneel, or crouch. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision and ability to adjust focus. The noise level in the work environment is usually quiet. The employee may be required to use any, or all of the following, on a daily basis: PC, telephone, cell phone, scanner, fax, printer and other office equipment.


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