Claims Quality Reviewer

Job Title: Claims Quality Reviewer





Monthly Pay: $8,000 - $8,600 USD per month





Summary:





The claims quality team partners with adjusters, claim supervisors, and policy service colleagues, receiving completed claim files and returning clear findings for correction and coaching. This fully remote, U.S.-based full-time associate role reviews payment, reserve, coverage, and documentation decisions against established procedures while supporting accurate financial outcomes.





Job Responsibilities:





• Review completed claim files for required documents, diary activity, notes, and payment support.

• Compare file handling decisions with coverage guidance, procedures, and quality standards.

• Sample files, score results, and record findings in quality review tools.

• Identify discrepancies affecting indemnity, expense, reserve accuracy, or service standards.

• Prepare concise audit findings and trend summaries for supervisors and operations partners.

• Coordinate with adjusters to clarify file activity and follow up on corrective actions.





Qualifications:





• Experience reviewing claims, billing, policy, or other regulated financial records.

• Working knowledge of claim file documentation, reserves, payments, and coverage terminology.

• Comfort interpreting written procedures and applying consistent review criteria.

• Proficiency using claim systems, spreadsheets, and document repositories.

• Ability to manage a review queue independently in a remote setting.





Perks & Benefits:





• Fully remote work with digital collaboration tools.

• Structured onboarding and quality-review training.

• Clear review standards and opportunities to build audit expertise.