Description

In this role, you will play a crucial part in enhancing the claims process by reviewing and managing delegated claims handling, overseeing the Expert Panel, and ensuring compliance with regulations. Your day-to-day responsibilities will involve collaborating with various teams to implement improvements and drive operational excellence.

Requirements

• •Extensive experience in a claim’s operational environment or equivalent
• •Knowledge of the regulatory environment for claims management and oversight
• •Familiarity with due diligence, performance management and audit requirements for outsourcing claims handling to third parties
• •Ability to build, maintain and influence relationships across an organisation
• •Experience in managing projects and delivering change initiatives
• •Strong Microsoft Office, specifically Microsoft Excel, and IT savvy
• •Aptitude and willingness to learn in-house and external claims systems
• •Excellent written and verbal communication skills
• •Fluency in English essential; knowledge of German, Dutch or Spanish an advantage
• •Positive mind-set and people-oriented work ethic
• •Legal right to live and work in the country of application
• •Consideration for flexible working patterns

Tasks

• •Review the delegated claims handling process
• •Conduct due diligence on coverholders and TPAs
• •Evaluate performance against SLAs
• •Produce delegated reports
• •Oversee the annual audit schedule
• •Manage the delegated claims handling process
• •Recommend process changes post-review
• •Review the Expert Panel process
• •Collaborate with Claims Divisional Heads and Legal
• •Implement changes for the Expert Panel's effectiveness
• •Ensure required TOBAs are in place
• •Oversee the Claims peer review process
• •Complete a sample of peer reviews
• •Collate and analyze peer review data
• •Work with Claims Divisional Heads to ensure timely submissions
• •Identify deficiencies and report improvements
• •Oversee the Claims Handling Manual
• •Collect feedback from the claims team for improvements
• •Manage the Claims Authority process
• •Streamline and enhance the Claims Authority process
• •Participate in market working groups for regulatory updates
• •Report on market initiatives and their impact
• •Manage Claims change initiatives
• •Recommend and deliver system upgrades and enhancements

Tools & Technologies

Benefits