Claims Quality Assurance Specialist
6 days ago
We 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 Responsibilities- Lead the implementation and execution of a technical file review program within the claims area of the business, covering multiple regions and jurisdictions.
- Develop and maintain a strong risk and control environment by reporting findings and results to senior leaders and key stakeholders.
- 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, 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.
- Obtain agreement with claims leaders and technical advisors on establishing best-in-class standards for audit and minimum thresholds for lines of business and file handling performance.
- 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, and existing processes.
- Problem-solving from root cause analysis on issues to developing and implementing solutions.
- Work with claims, actuarial, risk, IT, legal, compliance, finance, and underwriting teams.
- Foster awareness of company 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 a senior 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).
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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...
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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...
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Claims Quality Assurance Specialist
4 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...
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Claims Quality Assurance Specialist
4 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...
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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...
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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...
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