Claims Quality Auditor

7 months ago

Mississauga, Canada Beneva Full time

Job Posting Title:
Claims Quality Auditor

Status:
Regular

**Job Description**:
Under the immediate authority of the Director, the incumbent is responsible for evaluating the performance of activities related to claims processing. It carries out by sampling the hearing of claim files in order to meet the objectives of quality of service, productivity and profitability for the files of Unica and Beneva for personal and commercial insurance.

Summary of Role & Responsibilities:

- Analyze claims files, resolution processes and understand IT improvements.
- Review closed claims files for Unica and Beneva in the context of permanent hearings including automobile claims, bodily injury, statutory accidents benefits, water damage, fire, theft, civil liability and major claims at all levels.
- Evolve the methodology of the quality program and the tool.
- Update the file review and calibration questionnaire.
- Writes in the form of a report the findings as well as the improvements and action plans required following the hearing of the files in order to facilitate and improve the knowledge and efficiency of claims adjusters.
- Maintain close relationships with the managers concerned as regards the progress of the audit work, the results obtained and the proposed action plans.
- Procedure for updating standards or procedures if necessary.
- Act as a resource person for various workshops or development of IT projects.
- Participates in the implementation and achievement of the objectives of the quality assurance program.
- Participates in various committees including the prevention committee and the technical committee.
- Collaborates with the training team to validate the content of training for adjusters.
- Identifies avenues for improvement related to the Customer Experience Survey (TNR) with our customers, in particular by communicating them for feedback.
- Performs any other task at the request of his/her manager.

Necessary Knowledge, Skills and Attributes:

- Master Word office and Excel software.
- Demonstrate ease of expression and interpersonal skills.
- Demonstrate an ability to establish professional contacts with clients and lead conversations.
- Demonstrate leadership, good organization, judgment, initiative and team spirit.
- Demonstrate ability to analyze situations, take initiatives, demonstrate dynamism, diplomacy and discretion.

Education and Experience:

- University / College degree, preferably in related field
- Holding the title of P.A.A is an asset.
- The F.P.A.A. title is an asset.
- 6+ relevant experience in property claims in personal and commercial home or auto insurance, with knowledge of the rules specific to insurance in Ontario.
- Knowledge of English and French, both oral and written.

LI-Hybrid

LI-ENG
- L'Unique and Unica are equal opportunity employers, so we encourage all Women, persons with disabilities, Indigenous people as well as visible and ethnic minorities to apply._

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