Vitality, Claims Quality Audit Specialist, London, £Competitive + Bonus + Benefits.
Vitality is an award winning, dynamic and vibrant financial services provider, with a ground-breaking vision for the future, where individuals are enabled to succeed and are rewarded and recognised for their contribution to our business.
Our Claims Quality Audit Specialist will receive a competitive salary plus benefits including;
- Bonus
- A genuine long-term opportunity to grow and establish a long-term career.
- Our award winning private medical insurance.
- A comprehensive flexible benefits scheme.
- Stakeholder Pension Plan with employer contribution.
- Vitality Partners and Rewards
As our Claims Quality Audit Specialist you will carry out quality assurance checking of claims work in line with the strategic claims team’s risk based QA framework. This will include reporting on findings and highlighting risks to the business and ensuring any associated actions are followed up to mitigate any risks that are identified.
Responsibilities as our Claims Quality Audit Specialist include:
- Regularly select claims data for review to ensure the claims operations team are assessing claims within documented processes, plan provisions and delegated claim authorities.
- Complete the review of selected claims data in line with the claims risk-based QA framework and report findings to the business including any recommended actions to help mitigate any identified risks or gaps in knowledge or process.
- Ensure all actions identified from a QA review are fully completed and undertake any follow up reviews to ensure any risks or gaps in process have been addressed. This may include recommending specific training needs.
- Identify any training needs or knowledge gaps so the appropriate corrective and preventive corrective actions can be put in place.
- Carry out ad-hoc targeted reviews of claims data when requested by the business, including but not limited to declined claims, specific medical conditions, type of insured etc.
- Maintain the claims risk-based QA framework document which will include regular reviews to ensure it meets the needs of the business; amend the framework document accordingly.
- Oversee and help coordinate any internal, external and reinsurer audits of the claims operations team.
- Help quality assurance check work carried out by any outsourced claims service; this might include sight visits.
- Ensure ongoing compliance with quality and industry regulatory requirements by attending industry events and assisting with some claims work such as claims assessments.
Skills and experience required of our Claims Quality Audit Specialist:
- Advanced Excel and other database systems i.e. For scoring and recording findings.
- Intermediate word, PP
- Advanced claims assessment skills
- Advanced auditing skills including managing the whole process independently and liaising with senior staff to report findings.
- CII qualifications: Certificate or Diploma in Insurance especially the claims qualifications. (Desirable)
- Any Quality Assurance or auditing qualifications (Desirable)
Working for Vitality as a Claims Quality Audit Specialist you'll experience an exciting mix of creativity and innovation, within a framework of challenging objectives and a passion for delivering the best.
Our people are chosen for their skills, knowledge, enthusiasm and attitude but above all, their belief that anything can be achieved.
Closing Date: Tuesday 17 July 2022
If you feel you have the skills and experience to become our Claims Quality Audit Specialist please click ‘apply’ today.