Quality Assurance Manager
About The Position
At Gallagher Bassett, we're there when it matters most because helping people through challenging moments is more than just our job, it’s our purpose. Every day, we help clients navigate complexity, support recovery, and deliver outcomes that make a real difference in people’s lives. It takes empathy, precision, and a strong sense of partnership—and that’s exactly what you’ll find here. We’re a team of fast-paced fixers, empathetic experts, and outcomes drivers — people who care deeply about doing the right thing and doing it well. Whether you're managing claims, supporting clients, or improving processes, you’ll play a vital role in helping businesses and individuals move forward with confidence. Here, you’ll be supported by a culture that values teamwork, encourages curiosity, and celebrates the impact of your work. Because when you’re here, you’re part of something bigger. You’re part of a team that shows up, stands together, and leads with purpose. Ideal candidates will have Leadership experience in Workers' Compensation, jurisdictional knowledge and expertise preferred in California (CA), Oregon (OR), or New York (NY) (Northeast region). Open to all other jurisdictions. Remote 100%.
Requirements
- Bachelor's degree
- 9 years relevant claims handling experience in addition to proficiency in MS Office applications, and related claims and business software.
Nice To Haves
- Previous auditing experience in addition to extensive workers compensation claims background and strong process management skills.
Responsibilities
- Lead, mentor, and develop a team of claims professionals responsible for identifying, reviewing, and escalating potential internal fraud.
- Establish clear performance expectations, workflows, and quality standards to ensure accuracy, consistency, and timeliness of fraud reviews.
- Foster a culture of integrity, accountability, and continuous improvement across the team.
- Provide guidance on complex claims scenarios to ensure reviewers accurately identify red flags, anomalies, and deviations from expected handling.
- Monitor claim patterns, trends, and behaviors leveraging data, system cues, and review insights to refine detection strategies.
- Willing to develop familiarity and knowledge of claims system processes, controls, and data environment to support fraud reviews.
- Implement quality assurance checks to validate the completeness and integrity of case documentation.
- Share subject matter expertise to fraud risk assessments and recommendations to enhance existing controls to reduce risk across claims operations
- Collaborate with Financial Controls, Operations, , and IT to strengthen system‑based controls, triggers, and investigative workflows.
- Develop and maintain SOPs, escalation paths, and documentation standards for all fraud review activities.
- Oversee timely reporting on fraud trends, case outcomes, and emerging risks to senior leadership.
- Use data to identify root causes and partner with cross‑functional teams to implement corrective actions.
- Track team metrics and KPIs to measure effectiveness and drive continuous improvement in payment review processes.
Benefits
- Medical/dental/vision plans, which start from day one!
- Life and accident insurance
- 401(K) and Roth options
- Tax-advantaged accounts (HSA, FSA)
- Educational expense reimbursement
- Paid parental leave
- Digital mental health services (Talkspace)
- Flexible work hours (availability varies by office and job function)
- Training programs
- Gallagher Thrive program – elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing
- Charitable matching gift program
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What This Job Offers
Job Type
Full-time
Career Level
Manager
