Claims Quality Assurance Specialist
7 days ago
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- Work with Claims VPs and Directors, Actuarial and Insurance Risk teams to drive claims handling insights and impact while supporting Claims in their action planning and resolution
- Report findings and results 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
- 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 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 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)
We are Definity, a company that values inclusion, diversity, and equity. We are actively seeking diverse backgrounds and perspectives to help us make insurance better. If you are interested in this role but don't meet every requirement, we encourage you to apply. We know from experience that a candidate doesn't need 100% of the qualifications listed to bring incredible value to our team.
We offer a hybrid work schedule, company share ownership program, pension and savings programs, paid volunteer days, educational resources, and a focus on inclusion. We also provide discounts on products and services, wellness and recognition programs, and a positive compliance culture.
Actual salary for the role may vary depending on work location of the successful candidate and other factors including but not limited to, 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.
Our inclusive work environment welcomes diversity and supports accessibility. If you require accommodation at any time during the recruitment process, please let us know by contacting.
This role requires successful clearance of background checks (including criminal checks and leadership references).
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Claims Quality Assurance Specialist
6 days ago
Québec, Quebec, Canada Definity Full timeJob 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,...
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Claims Quality Assurance Specialist
5 days ago
Québec, Quebec, Canada Definity Full timeJob 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,...
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Claims Quality Assurance Specialist
4 days ago
Québec, Quebec, Canada Definity Full timeJob 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...
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Claims Quality Assurance Specialist
4 days ago
Québec, Quebec, Canada Definity Full timeJob 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...
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Claims Quality Assurance Specialist
1 month ago
Québec, Quebec, Canada Definity Full timeJob 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...
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Claims Quality Assurance Specialist
1 month ago
Québec, Quebec, Canada Definity Full timeJob 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...
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Claims Quality Assurance Specialist
1 week ago
Québec, Quebec, Canada Definity Full timeJob 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...
-
Claims Quality Assurance Specialist
1 week ago
Québec, Quebec, Canada Definity Full timeJob 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...
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Claims Quality Assurance Specialist
3 weeks ago
Québec, Quebec, Canada Definity Full timeJob 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...
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Claims Quality Assurance Specialist
3 weeks ago
Québec, Quebec, Canada Definity Full timeJob 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...
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Claims Quality Assurance Specialist
1 month ago
Québec, Quebec, Canada Definity Full timeJob 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...
-
Claims Quality Assurance Specialist
1 month ago
Québec, Quebec, Canada Definity Full timeJob 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...
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Claims Quality Assurance Specialist
4 weeks ago
Québec, Quebec, Canada Definity Full timeJob 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...
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Claims Quality Assurance Specialist
4 weeks ago
Québec, Quebec, Canada Definity Full timeJob 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...
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Claims Quality Assurance Specialist
3 weeks ago
Québec, Quebec, Canada Definity Full timeJob 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...
-
Claims Quality Assurance Specialist
4 weeks ago
Québec, Quebec, Canada Definity Full timeJob 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...
-
Claims Quality Assurance Specialist
3 weeks ago
Québec, Quebec, Canada Definity Full timeJob 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...
-
Claims Quality Assurance Specialist
3 weeks ago
Québec, Quebec, Canada Definity Full timeJob 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...
-
Claims Quality Assurance Specialist
3 weeks ago
Québec, Quebec, Canada Definity Full timeJob 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...
-
Claims Quality Assurance Specialist
3 weeks ago
Québec, Quebec, Canada Definity Full timeJob 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...
