Claims Quality Assurance Manager

Title:
Claims Quality Assurance Manager

Location:
Austin, TX / Dallas, TX (Hybrid)

Reporting to:
Director of Sales Operations

About Hippo:

Hippo exists to protect the joy of home ownership. We believe that insurance should protect the things you treasure through an intuitive, modern experience. We provide tailored insurance coverage and preventative maintenance plans that keep you protected throughout your homeowner journey. We’ll also help you find coverage for everything life brings—from auto to flood—reimagining how you care for your home.

About This Role:

We are seeking an experiencedClaim s Quality Assurance Managerto join our team reporting to our Director of Sales Operations. This role will help develop and implement program review standards for claims quality, consistency, and compliance and conduct claim file reviews. Then, in partnership with key internal claims stakeholders evaluate processes and internal controls to identify gaps and risks. You will provide feedback to ensure compliance is maintained and assist in training and knowledge sharing relating to claims best practices and risk identification and mitigation.

Audits will assist in optimizing program and individual adjuster’s level of review and overall performance and provide the foundation and support to make sure department goals are consistently met.

About You:

You are a team player who enjoys helping and developing others, and an overachiever driven to exceed expectations. You communicate effectively with individuals at all levels of an organization and are enthusiastic about working for a company that focuses on disrupting the norm. As a critical thinker, you excel at recognizing irregularities and preventing fraud. You are also comfortable conducting regular internal audits and risk assessments to identify and correct areas of non-compliance.

What You'll Do:

• Create an ongoing audit process
• Conduct end-to-end review forclaims
• Perform claims audits of best practices of nonaffiliated programs of the Company
• Review adherence to Hippo’s Claims and Estimating Guidelines and legal compliance
• Identify/verify:
  • Coding and math errors
  • Claims leakage
  • Fraud detection
• Prepare necessary reports with detailed documentation and citations to substantiate findings and corrective action plans
• Provide internal management and external programs with clear and actionable recommendations for process improvements and adjustments
• Develop and implement quality and compliance standards
• Facilitate compliance-related matters such as market conduct exams, and other requirements typical in a claims department
• Train staff on regulatory and claim compliance, including remedial training in response to gap analysis

Must Haves:

• 5+ years of successful handling of claims including advanced skills in coverage analysis, investigation, litigation management, negotiation, damage evaluation, customer service, vendor management, fraud detection, salvage, and subrogation
• Exceptional business judgment with the ability to create sound frameworks to drive decisions and organizational alignment
• Knowledge of and adherence to, the state laws and regulations governing the handling of property and casualty claims throughout the United States
• Excellent time management and organizational skills
• Prior auditing experience in a senior role
• Ability to quickly understand and utilize existing and future claims handling systems.
• Knowledge of best practice claims workflow as well as compliance guidelines
• Effective research and problem-solving skills, and the ability to multitask
• Has excellent communication skills and attention to detail

Nice to Haves:

• Management/Supervisory experience is a plus

Benefits and Perks

Hippo treats its team members with the same level of dedication and care as we do our customers, which is why we’re fortunate to provide all of our Hippos with:

• Healthy Hippos Benefits- Multiple medical plans to choose from and 100% employer covered dental & vision plans for our team members and their families. We also offer a 401(k)-retirement plan, short & long-term disability, employer-paid life insurance, Flexible Spending Accounts (FSA) for health and dependent care, and an Employee Assistance…