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Regional Claims Quality Assurance Officer
5 days ago
Job Requirements
This role works collaboratively with business partners to ensure compliance with COG Best Practices, claims guidelines, processes and country specific guidelines. Continuously improves the technical quality and operational performance of the claims product, measuring compliance through the use of file reviews. Supports the delivery and roll out of Best Practices and the QA process, leading training sessions throughout APAC. Facilitates calibration of QA process within the claims teams through re-reviews, training and feedback. Partners with various levels of internal and external claims management to analyse and communicate findings, recommend solutions, and assist in the development of meaningful action plans.
This position works closely with country Claims teams and Regional Lines of Business Claims Leaders. Partners with various levels of internal and external claims management to analyse and communicate findings, recommend solutions, and assist in the development of meaningful action plans.
**Responsibilities**:
Policy, Process and Procedures - Assists in the development and enhancement of COG Best Practice Guidelines. Technical Performance - Conducts Claim Technical Quality Reviews across multiple lines of business and languages of:
- COG Line of Business / Countries / Offices
- Third Party Administrators
- Claim Vendors & Suppliers
- Claims Operational Controls Reviews will be across multiple lines of business and languages. Leads the review and analysis of claims risks to ensure compliance with claims quality review policies and procedures, Chubb standards, and industry best practice. Prepare detailed working papers that evidence work performed, issues discovered and recommendations for improvement. Communicates claims expectations and ensure best practices are understood and implemented to ensure appropriate performance. Delivers training to managers throughout APAC on the audit process including the QA system and the calibration process to support QA quality. Continuously collaborates with claim management in the development of meaningful action plans that detail the tasks, resources, and timeframes necessary to improve claim handling. Facilitates, supports, and measures the execution of action plans. Provides consultation and advice to the claims teams to ensure the prompt and effective delivery of action plans. Leads or actively participates in training claim handlers on technical claims content. Interact with multiple business partners (Underwriting, Claims, Internal Audit, TPAs, Vendors, Accounts, Legal & Compliance etc.).
Work Experience
**Knowledge & Experience**:
**Desired Qualifications**:
Minimum 5 - 8 years of working experience in technical claims handling in insurance companies.
Degree / Diploma in Business, Insurance or Law preferred.
Flexibility to work within multiple time zones.
Ability to participate in on-site reviews involving international travel of consecutive 2 weeks each quarter.
Ability to learn and navigate claim systems effectively.
Ability to demonstrate high degree of credibility and influence among stakeholders supported.
Ability to analyze training needs and situations to determine if performance can be improved through training.
Excellent communication skills. Good personality.
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