Claims Quality Assurance Director

Claims Quality Assurance Director Rancho Cucamonga, CA Job Details $165,000 - $195,000 a year 1 day ago Benefits Health savings account Health insurance Dental insurance Paid time off Vision insurance Qualifications Performance dashboard reports Dashboard development Stakeholder engagement Managerial strategic planning Strategic management Phone communication 5 years Regulatory compliance in claims processing Data reporting Subrogation Training material drafting Improving operational efficiency Compliance management implementation Compensation administration Bachelor's degree in business administration Team development Hiring Litigation Quality assurance audits Analysis skills Bachelor's degree Loss control Team management Task prioritization Decision making Performance Improvement (PI) Employee relations management Risk management Mentoring Data interpretation Organizational skills IT Damages evaluation Business Administration Overseeing audit functions Employee engagement Auto insurance knowledge Senior level Cross-functional collaboration Business Leadership Data-driven decision making Communication skills Staffing management Technical Proficiency Negotiation Stakeholder relationship building Cross-functional communication Operational budget management Organizational budget management Staff development Stakeholder management

Full Job Description Description:

Description Aspire General Insurance Company and its affiliated general agent, Aspire General Insurance Services, are on a mission to deliver affordable specialty auto coverage to drivers without compromising outstanding service. Our company values can best be described with

ABLE :

to always do the right thing, be yourself, learn and evolve, and execute. Join our team where every individual takes pride in driving their role for shared success.

JOB SUMMARY

The Director of Claims Quality leads the design, execution, and continuous improvement of the organization's claims quality assurance program. This role partners cross-functionally with Claims Leadership, Training, Data & Analytics, and IT to enhance claims performance, elevate customer experience, ensure regulatory compliance, and reduce leakage. The Director drives data-informed strategies, builds high-performing teams, and embeds a culture of quality, accountability, and operational excellence across the claims organization. Key Responsibilities Claims Quality Strategy & Governance o Design, implement, and oversee a comprehensive claims audit program, including targeted audits, ad hoc reviews, and calibration sessions. o Establish quality standards, governance frameworks, and best practices across all claims functions. o Partner with executive leadership on strategic planning, goal setting, and budget oversight. Performance Monitoring & Improvement o Monitor and analyze claims performance across key metrics, including loss control, LAE, customer satisfaction, compliance, leakage, and employee engagement. o Translate audit findings and operational data into actionable insights, improvement plans, and measurable outcomes. o Develop and track KPIs, dashboards, and reporting to drive transparency and accountability. Cross-Functional Collaboration o Partner with Training to identify skill gaps and develop targeted learning solutions. o Collaborate with Data & Analytics to leverage insights and improve decision-making. o Work with IT to identify and implement systems and technology enhancements that improve accuracy and efficiency. Operational Excellence & Compliance o Ensure adherence to all state and federal regulations, including Department of Insurance requirements. o Lead the development, documentation, and continuous improvement of claims processes, procedures, and training materials. o Promote consistent application of best practices in coverage interpretation, investigation, evaluation, and negotiation. Leadership & Talent Development o Lead, mentor, and develop the Claims Quality team, fostering a high-performance, accountable culture. o Oversee workforce planning, hiring, performance management, compensation, and employee development. o Partner with Human Resources on employee relations, attendance, and compliance matters. Continuous Improvement o Proactively identify opportunities to enhance quality, customer satisfaction, and operational efficiency. o Champion innovation and continuous improvement initiatives across the claims organization.

Requirements:

QUALIFICATIONS AND SKILLS

Bachelor's degree required; preferred in Business Administration, Insurance, Risk Management, or related field 8+ years of experience in property & casualty claims operations and quality assurance 5+ years of leadership experience in claims management Prior experience in claims quality auditing preferred Strong experience with California claims handling; multi-state experience preferred Technical Expertise Strong understanding of claims systems, reserving practices, and regulatory requirements (especially California) Deep knowledge of automobile claims, including: Material damage (appraisal, total loss, salvage, subrogation) Bodily Injury and Liability claims (coverage, investigation, evaluation, negotiation) Litigation (injury and property damage) Proven ability to design and implement best practices in claims handling and quality assurance Core Competencies Strategic thinking and data-driven decision-making Strong analytical and problem-solving skills Executive-level communication and stakeholder management Organizational leadership and team development Ability to manage multiple priorities in a fast-paced environment High attention to detail and commitment to quality Interpersonal Effectiveness Builds strong relationships across internal teams, partners, and carriers Communicates clearly, professionally, and collaboratively Promotes a positive, team-oriented, and customer-focused culture Represents the organization with professionalism and integrity

WORKING CONDITIONS AND PHYSICAL REQUIREMENTS

Working Conditions:

This is a position based in a professional office environment or remote/hybrid setting, depending on company policy. Standard business hours apply, with occasional extended hours required to meet project deadlines or attend leadership meetings. Frequent use of a computer, phone system, and claims management software. Must be comfortable navigating multiple systems and screens simultaneously. Requires clear, professional verbal communication and active listening skills. Fast-paced environment with performance metrics. Must be able to manage time effectively and prioritize tasks. Frequent collaboration with cross-functional teams across time zones requiring flexibility in scheduling. May require occasional travel.

Physical Requirements:

Prolonged periods of sitting at a desk and working on a computer (up to 8 hours per day) while working on a desk computer. Frequent use of hands and fingers for typing, writing, and handling documents. Ability to use standard office equipment such as computers, phones, printers, and video conferencing tools. Must be able to read and interpret documents, emails, and computer screens. Extended screen time is required. Must be able to hear and speak clearly on the phone for extended periods. Use of a headset is common and may be required. Minimal physical movement required; occasional walking or standing may be needed. Must be able to lift up to 15 pounds occasionally (e.g., for transporting laptops or presentation materials).

Benefits:

Medical, Dental, Vision, HSA•, PTO, 401k, Company observed Holidays Individuals seeking employment at Aspire General Insurance Services LLC are considered without regards to race, color, religion, national origin, age, sex, marital status, ancestry, physical or mental disability, veteran status, gender identity, or sexual orientation in accordance with federal and state Equal Employment Opportunity/Affirmative Action record keeping, reporting, and other legal requirements.