Description
New Opportunity Great Team Environment in Preston
Purpose of the Role:
To ensure the accuracy, compliance, and efficiency of claims processing within a claims operation environment by conducting audits, identifying trends, and driving continuous process improvement initiatives.
Your New Role
Key Responsibilities:
Conduct regular audits of claims files to assess accuracy, completeness, and adherence to internal policies and regulatory standards.
* Identify errors, inconsistencies, or potential fraud, and escalate findings appropriately.
* Collaborate with claims handlers and team leaders to provide feedback and coaching based on audit results.
* Analyse audit data to identify systemic issues and recommend process enhancements.
* Develop and maintain audit tools, scorecards, and reporting dashboards.
* Support the implementation of corrective actions and monitor their effectiveness.
* Participate in cross-functional projects aimed at improving claims workflows and customer outcomes.
* Stay current with industry regulations, compliance requirements, and best practices.
Process Improvement Focus:
* Lead root cause analysis on recurring audit findings and inefficiencies.
* Partner with operational leaders to redesign workflows and eliminate waste.
* Contribute to the development of training materials and SOPs based on audit insights.
* Track and report on KPIs related to quality and process improvement.
* #INDUKI
What You'll Bring to the Role
* Experience in claims auditing within a TPA or insurance environment.
* Strong understanding of claims processes, regulatory compliance, and quality assurance principles.
* Analytical mindset with the ability to interpret data and identify trends.
* Excellent communication and interpersonal skills for delivering feedback and influencing change.
* 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 are committed to creating a diverse and inclusive environment and strongly encourage you to apply.
Benefits
Davies are committed to being a diverse and inclusive workplace. We welcome candidates of all genders, gender identity and expression, neurodiversity, sexual orientation, disability, physical appearance, body size, race, age, nationality, and belief (or lack thereof).
* Join us and enjoy our ever-evolving benefits, including but not limited to:
* Reward platform – discounts for over 800 retailers
* 25 days holiday (rising with service)
* Well-being centre
* Recognition programme
* Paid fertility appointments
* Fostering friendly employer
* Pension - matched contribution at 5%
* Life Assurance (4 x basic salary)
* Development, training, and professional qualification
We are a specialist professional services and technology firm, working in partnership with leading insurance, highly regulated and global businesses.
We help our clients to manage risk, operate their core business processes, transform and grow. We deliver professional services and technology solutions across the risk and insurance value chain, including excellence in claims, underwriting, distribution, regulation & risk, customer experience, human capital, digital transformation & change management.
Our global team of more than 8,000 professionals operate across ten countries, including the UK & the U.S. Over the past ten years Davies has grown its annual revenues more than 20-fold, investing heavily in research & development, innovation & automation, colleague development, and client service. Today the group serves more than 1,500 insurance, financial services, public sector, and other highly regulated clients.