Reviewer (QA Analyst) Hybrid - US

Reviewer (QA Analyst)

Full Time • Hybrid - US
Join Our National Team as a Reviewer! 

Are you looking to leverage your expertise to grow a role that offers varied and challenging work? Our company, a leading parent organization that owns and operates 300+ franchise locations across North America, seeks a Reviewer. 

In this role, you will serve as a member of the Claims Force Team (formerly known as the Quality Assurance). The primary responsibility of the Reviewer is to complete estimate and documentation reviews on direct program assignments for Service Level Compliance to carrier partner guidelines, estimating platform best practices, and based on industry standards, with work standards focused on accuracy, speed, and customer service. This position will assist with support of the department and network during a catastrophe event. 
 
Position: Reviewer
Reports to: Review Team Manager
Location:  Hybrid

Essential Duties/Responsibilities
  • Complete accurate and timely estimate and documentation reviews through our main technology platforms; XactAnalysis & Xactimate, Claims Connect & Mobile Claims, Validate, CMS, Mitigate, and other estimating/claim management platforms and software.
    • Accuracy of work is measured by estimate reinspection
    • Timeliness of work is measured by automated reporting between documented events
  • This position focuses on estimate, documentation, and commentary reviews for specific job types that include but are not limited to: water, mold, fire, tarping, board-up, biohazard, abatement, other emergency services, contents, and reconstruction.
    • These reviews include utilization of knowledge of industry standards, carrier guidelines, and estimating best practices to ensure adherence to carrier service level agreements
  • Communicate directly with franchisees and insurance carriers, to ensure that these requirements are being met.
    • Communication expectations include inbound and outbound phone calls, Validate, CMS, claim management system notes, email, MS Teams, and other potential software/communication applications 
  • Coach franchises on opportunities to improve their estimating and documentation performance 
  • Identify and communicate trends to Team Managers, Account Managers, Regional Business Coaches, and other organizational stakeholders.
  • Provide assistance to franchises on estimating requirements and claim expectations, based on carrier guidelines; and support technical claim inquiries across the estimating/claim management platforms. 
  • The support provided to the franchise network and carrier partners provides an opportunity for Paul Davis to obtain more jobs through improved scorecard performance.
 Competency – Knowledge, Skills, and Abilities: 
  • Proficient use of a laptop and operating accessories
  • Proficient use of Microsoft Office applications (Outlook, Teams, OneDrive, SharePoint, Forms, PowerPoint, Word, Excel)
  • General proficiency-level knowledge of the insurance industry, including but not limited to mitigation, contents, and reconstruction operational practices, and verbiage 
  • Ability to move through reviews of varying job types, estimate severity, and complexity
  • Assertive, professional communication skills - adaptive communication based on the context of the information being conveyed, both verbal and written
  • Proficient use of technology applications, including the creation of new documents
  • Ability to independently problem solve, resolve conflict, and manage priorities 
  • Ability to learn and implement new processes related to our industry and the specific duties and responsibilities required to be successful in this role
  • Ability to review estimates, documentation, and commentary in a timely manner with a focus on estimating accuracy
  • Ability to complete multiple reviews within a given time frame 
  • Knowledge of estimating platforms; Verisk, CoreLogic, Symbility, and other estimating software 
  • Knowledge of estimating principles for the insurance industry 
  • Ability to learn and operate our primary operating systems 
  • Ability to successfully pass required industry and company certifications on first attempt
  • Ability to answer and communicate with PDRI, Independent franchises and PDO offices via phone and email 
  • Ability to work office equipment (fax, scanner, printer, phone system, computers) 
  • Ability to work in our main operating systems 
  • Ability to work independently 
  • Ability to pass and maintain a satisfactory background check
  • Ability to maintain a level of confidentiality 
  • Other duties as assigned
Required Education and Experience 
  •  High School Diploma or GED
  • Bachelor’s degree or equivalent experience in insurance claims or related field 
  • One plus years experience with document review or similar analytical job experience.
 Preferred Education and Experience
  • Experience serving in a customer service role.
  • One plus years experience with industry estimating/estimate review.
  • Two plus years’ experience in the restoration industry regarding water mitigation, mold remediation, lead, and asbestos abatement, contents cleaning, contents packing, structure cleaning, and reconstruction.
  • Experience in the restoration industry regarding water mitigation/mold remediation, abatement, contents, fire structure cleaning, and reconstruction.
Physical Requirement
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. The employee is occasionally required to sit, climb, or balance, stoop, or kneel. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

  • Must be able to stay in a stationary position up to 100% of the time 
  • The person in this position needs to occasionally move about inside the office to access file cabinets, office machinery, etc.
  • Constantly operates a computer and other office productivity machinery, such as a calculator, fax machine, copy machine, and computer printer.
  • Must be able to observe and perceive information on a computer and documents 
  • Must be able to communicate and converse with customers over the phone 
  • Occasionally will lift up to 10lbs
  • Ability to safely operate a company vehicle  
Work Environment  
The employee will be working remotely in their home office and will be exposed to normal conditions of air conditioning and heat. Most work will be conducted over email, video conferencing, and telephone. Employee must have access to a stable internet connection when working out of the office.  Employee must use provided VPN technology to securely connect remotely. The successful person must be productive with minimal supervision.e. 
 
Travel   
This position may require up to 10% travel.  This position may require travel to franchise locations, trainings, and team meetings.   
 
Reasonable Accommodation for Disability   
Any applicant or employee, who believes that a reasonable accommodation is required for purposes of federal or state disability law is required to contact Human Resources to begin the interactive exchange process.
 
The ADA defines “reasonable accommodation” as a change or adjustment to a job or work environment that allows a qualified individual with a disability to satisfactorily perform the essential functions of a particular job and does not cause an undue hardship for the employer.

Disclaimer   
Paul Davis Restoration is an equal opportunity employer. Paul Davis Restoration provides equal employment opportunity to all individuals regardless of their race, color, creed, religion, gender, age, sexual orientation, national origin, disability, veteran status, or any other characteristic protected by state, federal, or local law.
 
The job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Other duties, responsibilities and activities may change or be assigned at any time with or without notice.

Flexible work from home options available.

Compensation: $42,000.00 - $47,000.00 per year

We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.





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Some Potential Benefits May Include:

Because Paul Davis is a franchise organization, benefits vary based on franchisee.

Opportunity for Overtime
Paid Time Off
Opportunity for Advancement
Great Company Culture