Audit and Quality Control Claims Specialist

Copperhead is seeking multiple Audit and Quality Control Claims Specialist for a potential contract to support disaster relief. This position involves receiving, evaluating, and processing claims for compensatory damages for injuries resulting from the Hermit's Peak/Calf Canyon fires. The role requires meticulous attention to detail and adherence to FEMA guidelines. Audit and Quality Control Claims Specialist will objectively review, investigate, process, and evaluate claims processed by the claims reviewer team. Specific responsibilities include but are not limited to: Ability to provide strong reporting and metrics evaluation and data to assist the team leads. Ability to support ancillary tasks for team lead and team members to efficiently process claims. Review submissions of comprehensive proofs of loss, claimant inquiries, review requested amounts, establish qualified amounts, assess duplication of benefits and provide comprehensive recommendations for maximum compensation determinations. Quality Control staff shall notify the Claims Reviewer of any items in the claim that require rework, additional documentation, or updated compensation determination. Provide technical assistance and expertise in support of the Hermit's Peak/Calf Canyon Claims Office (Claims Office), by receiving, evaluating, and processing claims for compensatory damages for injuries from the Hermit's Peak/Calf Canyon Fire. Communicate directly with claimants and/or claimant representatives to expedite claim processing, as requested by FEMA Navigators. Collaborate with local, state, and federal officials to identify eligible response, recovery, and mitigation activities. Advise clients on FEMA Public Assistance policy and documentation requirements. Prepare project damage descriptions, scope of work, and supporting documentation. Conduct site assessments in the field and prepare project documentation and cost estimates as required. Candidates are not required to be local in Sante Fe, NM but they must be willing to support on-site on a 6-10 shift schedule for 90-days at a time. Travel, lodging and per diem are provided. This position is contingent on contract award. Work Environment: Moderate noise (i.e. business office with computers, phone and printers) and /or occasional Loud noise (airfield, large equipment). Ability to sit at a computer terminal for an extended period of time. Physical Demands: While performing the responsibilities of the job, the employee is required to sit, stand, talk, and hear. Employee is often required to sit and use their hands and fingers to operate a computer. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Travel: 50%+ / Frequent travel. Copperhead, an operating firm of Command Holdings, a Pequot company, is a tribally-owned firm providing management consulting services to U.S. government agencies. Pursuant to PL 93-638, as amended, preference will be given to qualified Native Americans and spouses in all phases of employment. At Copperhead , our employees are the embodiment of our success as a firm. Our team is comprised of a tenacious group of professionals located across the globe. It includes military veterans and spouses of active duty troops, former federal employees, policy experts, academics, attorneys, and technical and business experts, all of whom share a strong work ethic and the skills to succeed in both collaborative and independent environments. Copperhead is invested in the long-term success of both our clients and colleagues for the right reasons. Our dedication to putting good government into practice is underpinned by a merit-based culture that measures success by productivity and credibility. Copperhead will provide reasonable accommodations to applicants who are unable to utilize our online application system due to a disability. Please send your request to the Human Resources Team. Copperhead is committed to equal employment opportunity based on merit. We recruit, employ, train, compensate, and promote without regard to race, religion, color, national origin, age, sex, disability, protected veteran status, or any other basis protected by applicable federal, state, or local law, and in accordance with EO 14173 and Federal Employment Laws: Equal Employment Opportunity and Employee Polygraph Protection Act.  Copperhead's Affirmative Action Program is available to any employee or applicant for employment for inspection upon request, to the extent required by federal regulations. The Affirmative Action Program can be accessed during normal business hours by making an appointment with the Human Resources Team. Requirements Basic Qualifications High school diploma. A minimum of (5) five years of combined experience in claim/case processing roles including customer service, data entry, reviewing, and evaluating various types of disaster related losses. Experience completing reviews in accordance with regulations, policy, and established program guidance. Experience in insurance claims, property inspection/assessment or a related field. Ability to interpret complex insurance policy language, including exclusions, endorsements, and coverage limits. Proficiency in assessing property, flooding, and/or fire-related damage accurately, including understanding the extent of damage, required repairs, documentation, and associated costs. Excellent written and verbal communication skills, with the ability to explain policies and regulations to claimants, FEMA Navigators, and other stakeholders effectively. Must be willing to support on-site on a 6-10 shift schedule for 90-days at a time. Outstanding communication skills, influencing abilities, and client focus. Demonstrated proficiency in using all Microsoft Office applications. Ability to pass a federal background investigation including fingerprinting. Must be able to obtain DHS suitability. Ability to access federal facilities in compliance with Real ID. More information about Real ID can be found here: https://www.dhs.gov/real-id/about-real-id and at https://www.tsa.gov/travel/security-screening/identification. Applicants must be currently authorized to work in the United States on a full-time basis. Copperhead will not sponsor applicants for work visas for this position. Preferred Qualifications Experience using Xactimate software. FEMA badge National Flood Insurance Program Certification (NFIP) Knowledge of FEMA Public Assistance program, eligibility criteria, laws, regulations, and policies, as well as familiarity with other FEMA programs (e.g., Individual Assistance, Hermit's Peak Program, etc.). Benefits Copperhead offers a competitive benefits plan including: Health, Dental, and Vision Insurance Flexible Spending Accounts Life and Disability Insurance 401(k) Paid Time Off Paid Holidays Employee Assistance Program Pet Insurance Eligibility requirements apply.