QA Specialist II

Salary Grade/Points

43/372 points

Company

FBL Financial Group, Inc.

Date Prepared

9/2020

Position Title

Quality Assurance Specialist II

Department

PC Operations

Job Number

PC6606

Location

West Des Moines, IA

Basic Function

Review underwriting and/or claim files in order to compare underwriting staff handling procedures to industry and company best practice guidelines and determine leakage within the underwriting and/or claims process. Identify training needs, mentoring opportunities, process enhancements and employee performance evaluation needs that will impact coverage, loss ratio, claim and/or underwriting expenses.

Principal Accountabilities

Accountabilities should reflect job functions requiring at least 5% of an incumbent's time commitment.

Essential Functions:

We deliver on our promise every day to protect livelihoods and futures. We do this through our value-based work, demonstrating service, integrity, leadership, teamwork, accountability, and passion in all touch points with client members, employees, agents and vendors.

1. Review claims and/or underwriting files across multiple lines of business in order to compare staff procedures to industry and company best practice guidelines. Determine if best claims and/or underwriting practices are being followed and, if not, work to ensure compliance.

2. Examine policy coverage options and/or policy interpretation to ensure risk and/or claim handling accuracy. Confirm established procedures are followed to ensure claim and/or underwriting decisions are appropriate.

3. Determine if coverage analysis is properly concluded based upon the individual risk facts. Make sure that all resources are used appropriately in the claims and/or underwriting decision-making process.

4. Examine file documentation to ascertain if proper justification to support the claims and/or underwriting decisions made within timelines assessed.

5. Analyze communication with all parties involved in the claims and/or underwriting process.

6. Consult with appropriate claims and/or underwriting resources as needed to make a proper evaluation of the risk and/or claim file.

7. Prepare reports, tune the audit process and distribute audit information to business centers, underwriters and/or claim representatives to ensure consistent audit procedures and processes across the eight-state region. Present results at business unit meetings.

Non-Essential Functions:

Perform other job-related duties or special projects as assigned.

Progress towards industry education outlined in career development path is expected. (AIC, AU, AFIS, CIC and CPCU)

Qualifications/Know-How

1. College degree or equivalent plus at least five years' underwriting experience or equivalent work experience required with a broad background in property, casualty insurance. Expertise in one or two lines of coverages preferred.

2. INS 21/22 required

3. AIC, API, or AU designation preferred

4. Ability to assist as needed in multiple quality assurance areas as needed or developing toward working with multiple insurance lines.

5. Analytical, problem solving, decision-making and organizational skills required.

6. Training skills, attention to detail and the ability to meet target dates is also required.

7. Must keep current with new claims and/or underwriter technologies/systems (P3, C4, Workflow, 360Value, etc.).

8. Must keep up-to-date regarding legislation, statutes, rules/regulations, and case law for all eight states.

9. A valid driver's license and satisfactory Motor Vehicle Records are required.

10. Some travel is required (including overnight) and must be able to work under all kinds of weather conditions.

11. Oral and written communication skills as appropriate to this position.

12. Ability to read, write and speak the English language.

13. Reasonably regular and predictable attendance.

OVER

Nature & Scope

The Education and Compliance Department is responsible for providing new hire and lifecycle training to the claims and underwriting staff, as well and ensuring compliance of Claims and Underwriting Best Practices through quality assurance reviews. Accurate payment of claim losses and underwriting rating accuracy contribute to the overall profitability of the Company; therefore, it is important that the department operates at a high-performance level to help ensure that the company remains competitive.

The Quality Assurance Specialist II is responsible for reviewing claim and/or underwriting files in order to compare staff handling procedures to company and industry best practice guidelines. The incumbent will also need to determine an amount of leakage that applies within the claims and/or underwriting department. The incumbent will identify training needs, mentoring opportunities, process enhancements and employee performance evaluation needs that will impact loss ratio, coverages, and expenses. The Quality Assurance Specialist II must be familiar with and understand the intricacies of the systems used by the company and knowledge of the products we offer.

Internal contacts include the Vice President Sales, Regional Vice Presidents, Agency Managers, and staff in the Information Technology, Claims, Underwriting, Product Development, Business Units, Marketing, Audit, and Public Relations departments. External contacts include reinsurers, vendors, government agencies and affiliated companies.

Dimensions

Education and Compliance Director

Not quantifiable

Direct reports: None

Note: The FBL Financial Group, Inc., reserves the right to change job descriptions at any time for business reasons. Furthermore, an employee is expected to perform the duties of the position in a safe manner and in accordance with the rules and regulations set forth by the department/division/area/company. Neither the provisions of this job description nor any other document or publication establishes a contract of employment between you and the FBL Financial Group, Inc., companies.

Profile: EI3 230, D3(29) 66, D2C 76, +1