Back to search
My client is an insurtech creating and incubating cutting-edge AI and automation technology to bring efficiency and simplicity to claims. Founded by insurtech veterans with deep experience in SaaS and digital claims, they are venture-backed by Bain Capital and Altai Ventures and began operations in May 2022. They are focused on automating highly manual tasks to tackle long-standing problems in claims and set a new standard for TPAs, insurance technology providers, and adjusters alike.
They have ambitious (but attainable!) goals and need people who can work in an evolving environment. If building a leading TPA and the prospect of tackling the long-standing challenges of the claims role sounds exciting, we can’t wait to meet you.
As a Quality Assurance Analyst, you will be responsible for ensuring the quality of claims processing through the implementation and management of quality assurance processes and procedures. You will analyse claims data and identify emerging patterns and gaps in existing processes to improve the overall claims process.
The role
- Conduct audits and reviews of claims to ensure compliance with industry regulations, company policies, and procedures, verifying that payments were made correctly and in accordance with appropriate plans and policies
- Analyse claims data to identify trends, patterns, and opportunities for improvement
- Develop and implement quality assurance processes and procedures to improve the overall claims process
- Maintain relationships our clients' audit teams, providing support when claims functions are being audited and managing action points
- Create reports and analysis on claims quality, including trends, patterns, and opportunities for improvement; communicate findings to Claims stakeholders and identify opportunities to increase use of data in identifying trends
- Identify and analyse potential risks and fraud within the claims process
- Assist with developing training materials, documentation, quick reference guides and help to facilitate training sessions with the claims team
- Stay up-to-date on industry trends, regulations, and best practices related to claims quality assurance
- Participate in both internal and external audits as needed
Requirements
- Solid experience in claims quality assurance or a related field
- Experience with claims and unfair practices act statutory compliance preferred
- Strong analytical skills and attention to detail
- Ability to work independently and as part of a team in a fast-paced environment
- Strong familiarity with industry best practices, but an equally strong comfort in thinking critically about easier, even better ways of working
- Experience with data analytics tools
- Ideally, prior claim adjuster handling experience
Benefits
- Generous health-insurance package with nationwide coverage, vision, & dental
- Pension plan with employer contributions
- Competitive holiday / leave policy in addition to bank holidays - we want our employees fresh, healthy, happy, and energized!
- Industry Qualifications paid by us (after a qualifying period)
- Work from anywhere to facilitate your work life balance
- Apple laptop, large second monitor, and other quality-of-life equipment you may want. Technology is something that should make your life easier, not harder!
