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Our client, a rapidly growing automotive service contract administration company in Northwest Austin, is seeking a Claims Integrity & Loss Control Specialist to proactively identify fraudulent activity, claim leakage, and process inefficiencies. This role will focus on auditing claims, analyzing trends, and partnering with internal stakeholders to protect financial performance and ensure compliance with company policies. This individual will play a key role in identifying patterns, telling data-driven stories, and driving actionable improvements across the organization. This is a 6 month contract to hire. It is a hybrid role with Monday and Friday being remote days, and the hours are 8-5 with an hour lunch break.
Job Responsibility:
Perform detailed audits of claims, including review of repair details, part replacements, photos, and supporting documentation
Analyze claims data to identify irregular patterns, fraud indicators, and process inefficiencies
Investigate duplicate submissions, unsupported repairs, and estimate inconsistencies
Leverage internal data tools and analytics platforms to uncover trends and high-risk behaviors
Translate findings into clear, actionable insights for risk, sales, and executive teams
Collaborate cross-functionally to address non-compliant behavior and improve claims processes
Monitor and improve claims handling procedures and documentation standards
Assist in building and refining internal audit and fraud detection processes
Maintain thorough documentation and reporting on findings, trends, and financial impact
Requirements:
3+ years of claims handling, auditing, or investigative experience (2+ years considered for strong candidates)
Strong understanding of claims lifecycle, contract coverage, and adjudication processes
Experience reviewing detailed claim components such as part numbers, photos, and repair documentation
Background in insurance or related claims environments preferred
Analytical mindset with ability to work with data and identify trends
Experience with analytics tools such as Tableau, Looker, Sigma, or Power BI preferred
Strong communication skills with ability to present findings across multiple levels of the organization
High attention to detail and strong organizational skills
Ability to manage multiple priorities and adapt in a fast-paced environment
Nice to have:
Background in insurance or related claims environments preferred
Experience with analytics tools such as Tableau, Looker, Sigma, or Power BI preferred