Responsibilities
: Conduct regular audits of claims files to assess accuracy,pleteness, and adherence to internal policies and regulatory standards.
1. Identify errors, inconsistencies, or potential fraud, and escalate findings appropriately.
2. Collaborate with claims handlers and team leaders to provide feedback and coaching based on audit results.
3. Analyse audit data to identify systemic issues and rmend process enhancements.
4. Develop and maintain audit tools, scorecards, and reporting dashboards.
5. Support the implementation of corrective actions and monitor their effectiveness.
6. Participate in cross-functional projects aimed at improving claims workflows and customer oues.
7. Stay current with industry regulations,pliance requirements, and best practices.
Process Improvement Focus:
8. Lead root cause analysis on recurring audit findings and inefficiencies.
9. Partner with operational leaders to redesign workflows and eliminate waste.
10. Contribute to the development of training materials and SOPs based on audit insights.
11. Track and report on KPIs related to quality and process improvement.
12. #INDUKI
What You'll Bring to the Role
13. Experience in claims auditing within a TPA or insurance environment.
14. Strong understanding of claims processes, regulatorypliance, and quality assurance principles.
15. Analytical mindset with the ability to interpret data and identify trends.
16. Excellentmunication and interpersonal skills for delivering feedback and influencing change.
17. Proficiency in audit software, claims management systems, and Excel.
Desirable Qualifications: Familiarity with FCA regulations and TCF (Treating Customers Fairly) principles.
Not sure you meet all qualifications? Let us decide! Research shows that women and members of other under-represented groups tend to not apply to jobs when they think they may not meet every qualification, when in fact, they often do! We aremitted to creating a diverse and inclusive environment and strongly encourage you to apply.
Benefits
Davies aremitted to being a diverse and inclusive workplace. We wee candidates of all genders, gender identity and expression, neurodiversity, sexual orientation, disability, physical appearance, body size, race, age, nationality, and belief (or lack thereof).
18. Join us and enjoy our ever-evolving benefits, including but not limited to:
19. Reward platform - discounts for over 800 retailers
20. 25 days holiday (rising with service)
21. Well-being centre
22. Recognition programme
23. Paid fertility appointments
24. Fostering friendly employer
25. Pension - matched contribution at 5%
26. Life Assurance (4 x basic salary)
27. Development, training, and professional qualification
Job ID 9dae0e47-ed67-4730-8b46-95cc7a07b3af