Claims Quality Specialist, Governance Expert

2 weeks ago


Montreal, Quebec, Canada Definity Financial Full time
Job Description

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, 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 technical file review program to ensure claims accuracy and compliance.
  • Lead a team of specialists to review and analyze claims data.
  • Collaborate with cross-functional teams to identify and address claims quality issues.
  • Develop and maintain technical guidelines and procedures for claims review.
Requirements
  • Strong technical knowledge of claims processing and quality assurance.
  • Excellent leadership and communication skills.
  • Ability to analyze complex data and identify quality issues.
  • Experience with technical file review and claims quality assurance.


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