Claims Quality Control Auditor - Lead

Title: Claims Quality Control Auditor - Lead

Location: Dallas, TX / Austin, TX

Reporting to: Director of Sales Operations

Our mission is to deliver intuitive and proactive protection for homeowners, combining the power of technology with a human touch.

Hippo built the world’s first home protection platform. We believe that insurance should protect your home and the things you treasure with policies designed for modern lives and proactive protection that helps you care for your home. Our aim is to help you avoid issues before they become costly problems because the best claims experience is the one you don’t have. Simply put, Hippo exists to protect the joy of homeownership!

 

About This Role:

We are seeking an experienced Claims Quality Control Auditor to 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 collaborative team player who takes pride in helping and developing others. Driven to exceed expectations, you consistently strive to achieve more and deliver outstanding results. Your strong communication skills allow you to effectively engage with individuals at all levels of an organization. You are passionate about working for companies that challenge the status quo and are focused on disrupting the norm. With a keen eye for detail, you are a critical thinker who can identify irregularities and take proactive measures to prevent fraud. You are also comfortable conducting regular internal audits and risk assessments, ensuring non-compliant areas are identified and addressed promptly. 

What You'll Do:

• Create an ongoing audit process
• Conduct end-to-end review for claims
• Perform claimsaudits of best practices of nonaffiliated programs of the Company
• Review adherence to Hippo’s Claimsand 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 claimsthroughout 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 claimshandling systems.
• Knowledge of best practice claimsworkflow as well as compliance guidelines
• Effective research and problem-solving skills, and the ability to multitask
• Has excellent communication skills and attention to detail

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 Program (EAP)
• Equity -This position is eligible for equity compensation 
• Training and Career Growth– Training and internal career growth opportunities
• Flexible Time Off- You know when and how you should recharge
• Little Hippos Program- We offer 12 weeks of parental leave for primary and secondary caregivers 

Hippo is an equal opportunity employer, and we are committed to building a team culture that celebrates diversity and inclusion.

Hippo’s applicants are considered solely based on their qualifications, without regard to an applicant’s disability or need for accommodation. Any Hippo applicant who requires reasonable accommodations during the application process should contact the Hippo’s People Team to make the need for an accommodation known.