Claims Quality Specialist, Governance
2 months ago
The Specialist, National Claims Quality Assurance will lead the implementation and execution of a technical file review program within the claims area of the business including coverage of multiple regions/jurisdictions. This Line 1 defense mechanism for Claims ensures our claims file handlers and leaders are:
- Meeting customer expectations
- Ensuring case reserves are timely and accurate
- Managing claims according to regulatory requirements
- Adhering to other file handling practices to Definity standards
- Work with Claims VPs and Directors, Actuarial and Insurance Risk teams within the Quebec region to drive claims handling insights and impact while supporting Claims in their action planning and resolution
- Report findings and results (Claims Risk & Control and Reserving committee/sub-committee) to promote a strong risk and control environment, Risk & Reserving committees, senior leaders and other key stakeholders as required
- Support the development of claims technical file review audit methodology framework and processes
- Provide input/insight in developing the annual audit plan
- Support the development of audit quality standards for each step of the audit process such as: testing scripts and interpretation notes, working papers, etc.
- Complete file reviews
- Make recommendations on findings, agreeing with key claims stakeholders to appropriately manage risk
- Manage internal and external resources supporting this work
- Recommend and influence any necessary changes to company policies, guidelines and best practices
- Ensure all reviewers (Claims Leaders, Claims Technical Advisors, Claims Quality Assurance) are calibrated for a consistent approach in auditing claims files
- Obtain agreement with Claims Leaders and Claims Technical Advisors on establishing best-in-class standards for audit and minimum thresholds for lines of business and file handling performance, including developing leakage methodology
- Incorporate data analytics to measure and monitor adherence to regulatory and company standards, including idea generation, designing automated testing procedures and investigating potential gaps and incorporating findings into the reporting process
- Provide advisory and consultative services on claims file management, claims process effectiveness, risk management and control on new initiatives, process changes, existing processes and from ad hoc requests
- Problem solving from root cause analysis on issues to developing and implementing solutions
- Work with Claims, Actuarial, Risk, IT, Legal & Compliance, Finance and Underwriting
- Foster awareness of the company's policies and procedures through regular communication, training and employee engagement
- Help to implement any new requirements, controls, close action items as needed, including assisting with new regulatory requirements, process and controls mapping/documentation, framework updates and/or development
- Monitor emerging best practices in risk management, audit and control to improve the organization's ability to identify, assess, mitigate, govern and report
- Develop techniques to make control testing more efficient and effective
- Strong 10+ years claims career including; 5+ years as Sr. Adjuster and/or Specialist
- Experience in minimum 2 lines of claims business (Auto, Property, Bodily Injury/Casualty)
- Experience in audit, risk management, regulatory compliance, processes and controls is preferred but not necessary
- Experience as a claims leader is an asset but not necessary
- Strong stakeholder management skills
- Strong understanding of business operations and related legislative, regulatory and internal policy and procedure requirements
- Excellent analytical, written and verbal communication skills
- Ability to build strong relationships externally and internally at all levels to help foster a positive compliance culture
- Proficient in Excel, Powerpoint and Word
- Strong organizational and problem-solving skills with the ability to gather information, analyze critically and cut through complexities to arrive at workable solutions
- Strong level of personal integrity
- Highly Positive attitude and open minded
- Thrives in a team environment and ability to also work independently
- Bilingualism is mandatory (French/English)
Definity is the parent company to some of Canada's most long-standing and innovative insurance brands, including Economical Insurance, Sonnet Insurance, Family Insurance Solutions, and Petline Insurance. Our ambition is to be one of Canada's leading and most innovative property and casualty insurers. We can't do that without our people, so we embrace and encourage a culture that's collaborative, ambitious, rewarding, and empowering.
We offer a flexible, hybrid work experience where employees work from the office and virtually depending on the type of work they are doing and who they are working with. Bring your true self and be a part of our journey. It's better here.
-
Claims Quality Specialist, Governance
7 days ago
Montreal, Quebec, Canada Definity Financial Full timeJob Title: Specialist, National Claims Quality Assurance Join our team at Definity, a leading property and casualty insurer in Canada, as a Specialist, National Claims Quality Assurance. In this role, you will lead the implementation and execution of a technical file review program within the claims area of the business, ensuring our claims file handlers...
-
Montreal, Quebec, Canada Definity Financial Full timeJob DescriptionThe Specialist, National Claims Quality Assurance will lead the implementation and execution of a technical file review program within the claims area of the business, covering multiple regions and jurisdictions. This line of defense for Claims ensures our claims files are accurate and compliant.Key Responsibilities:Develop and implement a...
-
Montreal, Quebec, Canada Definity Financial Full timeJob DescriptionThe Specialist, National Claims Quality Assurance will lead the implementation and execution of a technical file review program within the claims area of the business, covering multiple regions and jurisdictions. This line of defense for Claims ensures our claims files are accurate and compliant.Key Responsibilities:Develop and implement a...
-
Claims Quality Assurance Specialist
6 days ago
Montreal, Quebec, Canada Definity Financial Full timeJob SummaryWe are seeking a highly skilled Claims Quality Assurance Specialist to join our team at Definity Financial. As a key member of our organization, you will play a critical role in ensuring the quality and integrity of our claims handling processes.Key ResponsibilitiesLead the implementation and execution of a technical file review program within the...
-
Claims Quality Assurance Specialist
6 days ago
Montreal, Quebec, Canada Definity Financial Full timeJob SummaryWe are seeking a highly skilled Claims Quality Assurance Specialist to join our team at Definity Financial. As a key member of our organization, you will play a critical role in ensuring the quality and integrity of our claims handling processes.Key ResponsibilitiesLead the implementation and execution of a technical file review program within the...
-
Claims Quality Assurance Specialist
4 days ago
Montreal, Quebec, Canada Definity Financial Full timeJob SummaryWe are seeking a highly skilled Claims Quality Assurance Specialist to join our team at Definity Financial. As a key member of our organization, you will play a critical role in ensuring the quality and integrity of our claims handling processes.Key ResponsibilitiesLead the implementation and execution of a technical file review program within the...
-
Claims Quality Assurance Specialist
2 days ago
Montreal, Quebec, Canada Definity Financial Corporation Full timeAbout the RoleWe are seeking a highly skilled Claims Quality Assurance Specialist to join our team at Definity Financial Corporation. As a key member of our organization, you will play a critical role in ensuring the quality and integrity of our claims handling processes.Key ResponsibilitiesLead the implementation and execution of a technical file review...
-
Claims Quality Assurance Specialist
3 days ago
Montreal, Quebec, Canada Definity Financial Corporation Full timeAbout the RoleWe are seeking a highly skilled Claims Quality Assurance Specialist to join our team at Definity Financial Corporation. As a key member of our organization, you will play a critical role in ensuring the quality and integrity of our claims handling processes.Key ResponsibilitiesLead the implementation and execution of a technical file review...
-
Montreal, Quebec, Canada Definity Financial Corporation Full time $66,300 - $122,100Job SummaryWe are seeking a highly skilled and experienced Claims Quality Assurance Specialist to join our team at Definity Financial Corporation. As a key member of our Claims department, you will play a critical role in ensuring the quality and accuracy of our claims handling processes.Key ResponsibilitiesLead the implementation and execution of a...
-
Montreal, Quebec, Canada Definity Financial Corporation Full time $66,300 - $122,100Job SummaryWe are seeking a highly skilled and experienced Claims Quality Assurance Specialist to join our team at Definity Financial Corporation. As a key member of our Claims department, you will play a critical role in ensuring the quality and accuracy of our claims handling processes.Key ResponsibilitiesLead the implementation and execution of a...
-
Governance and Compliance Expert
6 days ago
Montreal, Quebec, Canada Definity Financial Full timeAbout the RoleWe are seeking a highly skilled Claims Quality Assurance Specialist to join our team at Definity Financial. As a key member of our organization, you will play a critical role in ensuring the quality and integrity of our claims handling processes.Key ResponsibilitiesLead the implementation and execution of a technical file review program within...
-
Governance and Compliance Expert
4 days ago
Montreal, Quebec, Canada Definity Financial Full timeAbout the RoleWe are seeking a highly skilled Claims Quality Assurance Specialist to join our team at Definity Financial. As a key member of our organization, you will play a critical role in ensuring the quality and integrity of our claims handling processes.Key ResponsibilitiesLead the implementation and execution of a technical file review program within...
-
Claims Specialist
3 weeks ago
Montreal, Quebec, Canada BFL Canada Full timeJoin a dynamic team as a Claims SpecialistWe are seeking a dedicated Claims Specialist to join our team, where you will play a crucial role in managing client claims effectively. Your primary responsibilities will involve assessing client claims by reviewing relevant insurance policies, investigating incidents, analyzing coverage details, and communicating...
-
Claims Specialist
3 weeks ago
Montreal, Quebec, Canada Coalition Assurance Full timePosition: Claims SpecialistLocation: MontrealOverviewCoalition Assurance is seeking a dedicated Claims Specialist to enhance our team in Montreal.Key Responsibilities:Managing all facets of insurance claims for clientsAssessing claims to ascertain coverage, damages, liability, and settlement optionsEngaging in negotiations with involved parties (appraisers,...
-
Automobile Claims Specialist
3 weeks ago
Montreal, Quebec, Canada Intact Financial Corporation Full timePosition OverviewAs an Automobile Claims Specialist, you will be responsible for managing a variety of claims related to vehicle incidents. Your expertise will be essential in evaluating coverage and ensuring that claims are resolved in a just manner.Key ResponsibilitiesAssess and process new claims with precision.Determine the appropriate coverage based on...
-
Bilingual Quality Assurance Specialist
1 day ago
Montreal, Quebec, Canada Definity Financial Corporation Full timeThe Specialist, National Claims Quality Assurance will lead the implementation and execution of a technical file review program within the claims area of the business, including coverage of multiple regions/jurisdictions. This Line 1 defense mechanism for Claims ensures our claims file handlers and leaders are:Managing claims according to regulatory...
-
Bilingual Quality Assurance Specialist
2 days ago
Montreal, Quebec, Canada Definity Financial Corporation Full timeThe Specialist, National Claims Quality Assurance will lead the implementation and execution of a technical file review program within the claims area of the business, including coverage of multiple regions/jurisdictions. This Line 1 defense mechanism for Claims ensures our claims file handlers and leaders are:Managing claims according to regulatory...
-
Claims Specialist
3 weeks ago
Montreal, Quebec, Canada HSB, Canada Full timeBecome a part of our team as a Claims SpecialistHSB Canada stands at the forefront of specialized insurance solutions and innovative technology. Our commitment to identifying emerging trends allows us to create new opportunities for our clients, effectively transforming the landscape of insurance and risk management in today's world.We recognize and...
-
Liability Claims Specialist
2 weeks ago
Montreal, Quebec, Canada Travelers Full timeJob Summary:We are seeking a highly skilled Liability Claims Specialist to join our team at Travelers. As a key member of our claims department, you will be responsible for handling severe liability claims and providing exceptional customer service to our insured parties.Key Responsibilities:Investigate claims thoroughly by contacting relevant parties and...
-
Bilingual Content Claims Specialist
4 days ago
Montreal, Quebec, Canada Crawford & Company Full timeJob SummaryCrawford & Company is seeking a highly skilled Bilingual Content Claims Specialist to join our team in Montreal, Quebec, Canada. As a Content Claims Specialist, you will play a critical role in handling content claims, providing exceptional customer service, and ensuring timely and accurate processing of claims.Key ResponsibilitiesConduct onsite...
