Claims Quality Assurance Specialist

3 weeks ago


Québec, Quebec, Canada Definity Full time
Job Summary

We are seeking a highly skilled Claims Quality Assurance Specialist to lead the implementation and execution of a technical file review program within the claims area of the business. This role will ensure our claims file handlers and leaders are meeting customer expectations, ensuring timely and accurate case reserves, managing claims according to regulatory requirements, and adhering to Definity standards.

Key Responsibilities
  • Lead the development and execution of a technical file review program to ensure compliance with regulatory requirements and Definity standards.
  • Work with Claims VPs and Directors, Actuarial and Insurance Risk teams to drive claims handling insights and impact.
  • Report findings and results to promote a strong risk and control environment.
  • Support the development of claims technical file review audit methodology framework and processes.
  • Provide input and insight in developing the annual audit plan.
  • Support the development of audit quality standards for each step of the audit process.
  • Complete file reviews and make recommendations on findings.
  • Manage internal and external resources supporting this work.
  • Recommend and influence any necessary changes to company policies, guidelines, and best practices.
  • Ensure all reviewers are calibrated for a consistent approach in auditing claims files.
  • Incorporate data analytics to measure and monitor adherence to regulatory and company standards.
  • Provide advisory and consultative services on claims file management, claims process effectiveness, risk management, and control.
  • Problem-solving from root cause analysis on issues to developing and implementing solutions.
Requirements
  • 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).
About Us

Definity is a company that values inclusion, diversity, and equity. We are committed to creating a workplace that is welcoming and inclusive for all employees. We offer a range of benefits, including a hybrid work schedule, company share ownership program, pension and savings programs, paid volunteer days, and educational resources.

Actual salary for the role may vary depending on work location of the successful candidate and other factors including but not necessary, skills, education, experience, working conditions, and the local labour market. In addition to base pay, eligible employees may participate in various incentive plans which are paid out at the discretion of the company and subject to individual and company performance.



  • Québec, Quebec, Canada Definity Full time

    Job Title: Claims Quality Assurance Specialist, GovernanceDefinity is seeking a highly skilled Claims Quality Assurance Specialist, Governance to lead the implementation and execution of a technical file review program within the claims area of the business. This role will ensure that our claims file handlers and leaders are meeting customer expectations,...


  • Québec, Quebec, Canada Definity Full time

    Job Title: Claims Quality Assurance Specialist, GovernanceDefinity is seeking a highly skilled Claims Quality Assurance Specialist, Governance to lead the implementation and execution of a technical file review program within the claims area of the business. This role will ensure that our claims file handlers and leaders are meeting customer expectations,...


  • Québec, Quebec, Canada Definity Full time

    Job SummaryWe are seeking a highly skilled Claims Quality Assurance Specialist to lead the implementation and execution of a technical file review program within the claims area of the business. This role will ensure our claims file handlers and leaders are meeting customer expectations, ensuring case reserves are timely and accurate, managing claims...


  • Québec, Quebec, Canada Definity Full time

    Job SummaryWe are seeking a highly skilled Claims Quality Assurance Specialist to lead the implementation and execution of a technical file review program within the claims area of the business. This role will ensure our claims file handlers and leaders are meeting customer expectations, ensuring case reserves are timely and accurate, managing claims...


  • Québec, Quebec, Canada Definity Full time

    Job SummaryWe are seeking a highly skilled Claims Quality Assurance Specialist to join our team at Definity. As a key member of our Governance and Compliance department, 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...


  • Québec, Quebec, Canada Definity Full time

    Job SummaryWe are seeking a highly skilled Claims Quality Assurance Specialist to join our team at Definity. As a key member of our Governance and Compliance department, 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...


  • Québec, Quebec, Canada Definity Full time

    Job SummaryWe are seeking a highly skilled Claims Quality Assurance Specialist to lead the implementation and execution of a technical file review program within the claims area of the business. This role will ensure our claims file handlers and leaders are meeting customer expectations, ensuring case reserves are timely and accurate, managing claims...


  • Québec, Quebec, Canada Definity Full time

    Job SummaryWe are seeking a highly skilled Claims Quality Assurance Specialist to lead the implementation and execution of a technical file review program within the claims area of the business. This role will ensure our claims file handlers and leaders are meeting customer expectations, ensuring case reserves are timely and accurate, managing claims...


  • Québec, Quebec, Canada Definity Full time

    Job SummaryWe are seeking a highly skilled Claims Quality Assurance Specialist to lead the implementation and execution of a technical file review program within the claims area of the business. This role will ensure our claims file handlers and leaders are meeting customer expectations, ensuring timely and accurate case reserves, managing claims according...


  • Québec, Quebec, Canada Definity Full time

    Job SummaryWe are seeking a highly skilled Claims Quality Assurance Specialist to lead the implementation and execution of a technical file review program within the claims area of the business. This role will ensure our claims file handlers and leaders are meeting customer expectations, ensuring timely and accurate case reserves, managing claims according...


  • Québec, Quebec, Canada Definity Full time

    Job SummaryWe are seeking a highly skilled Claims Quality Assurance Specialist to join our team at Definity. As a key member of our Governance and Compliance department, 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...


  • Québec, Quebec, Canada Definity Full time

    Job SummaryWe are seeking a highly skilled Claims Quality Assurance Specialist to join our team at Definity. As a key member of our Governance and Compliance department, 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...


  • Québec, Quebec, Canada Definity Full time

    Job SummaryWe are seeking a highly skilled Claims Quality Assurance Specialist to join our team at Definity. This role will be responsible for leading the implementation and execution of a technical file review program within the claims area of the business, ensuring compliance with regulatory requirements and adherence to company standards.Key...


  • Québec, Quebec, Canada Definity Full time

    Job SummaryWe are seeking a highly skilled Claims Quality Assurance Specialist to join our team at Definity. This role will be responsible for leading the implementation and execution of a technical file review program within the claims area of the business, ensuring compliance with regulatory requirements and adherence to company standards.Key...


  • Québec, Quebec, Canada Definity Full time

    Job SummaryWe are seeking a highly skilled Claims Quality Assurance Specialist to lead the implementation and execution of a technical file review program within the claims area of the business. This role will ensure our claims file handlers and leaders are meeting customer expectations, ensuring timely and accurate case reserves, managing claims according...


  • Québec, Quebec, Canada Definity Full time

    Job SummaryWe are seeking a highly skilled Claims Quality Assurance Specialist to lead the implementation and execution of a technical file review program within the claims area of the business. This role will ensure our claims file handlers and leaders are meeting customer expectations, ensuring timely and accurate case reserves, managing claims according...


  • Québec, Quebec, Canada Definity Full time

    Job SummaryWe are seeking a highly skilled Claims Quality Assurance Specialist to lead the implementation and execution of a technical file review program within the claims area of the business. This role will ensure our claims file handlers and leaders are meeting customer expectations, ensuring timely and accurate case reserves, managing claims according...


  • Québec, Quebec, Canada Definity Full time

    Job SummaryWe are seeking a highly skilled Claims Quality Assurance Specialist to lead the implementation and execution of a technical file review program within the claims area of the business. This role will ensure our claims file handlers and leaders are meeting customer expectations, ensuring timely and accurate case reserves, managing claims according...


  • Québec, Quebec, Canada Definity Full time

    Job SummaryWe are seeking a highly skilled Claims Quality Assurance Specialist to lead the implementation and execution of a technical file review program within the claims area of the business. This role will ensure our claims file handlers and leaders are meeting customer expectations, ensuring timely and accurate case reserves, managing claims according...


  • Québec, Quebec, Canada Definity Full time

    Job SummaryWe are seeking a highly skilled Claims Quality Assurance Specialist to lead the implementation and execution of a technical file review program within the claims area of the business. This role will ensure our claims file handlers and leaders are meeting customer expectations, ensuring timely and accurate case reserves, managing claims according...