• Perform end-to-end claim quality reviews and identify trends, risks, and operational gaps

• Analyze reserve adequacy and provide insights to claims leadership

• Prepare structured reports, dashboards, and quality metrics for decision-making

• Collaborate with cross-functional teams including actuarial, underwriting, audit, and TPAs

• Support development of workflows, quality frameworks, and training programs

• Ensure compliance with regulatory requirements and internal governance standards

• Lead planning, execution, and reporting of quality review processes

• Identify improvement opportunities and support continuous process optimization

• Maintain documentation and ensure audit readiness across claims operations

• Monitor operational performance and escalate critical issues when required