Location: 

Mexico City, MX Madrid, M, MX Sao Paulo, São Paulo, MX

Claims Specialist

Claims Quality Assurance Specialist

Flexible Locations: Mexico, Sao Paulo, Madrid

 

About the Role


In this role, you will assist the Corporate Solutions (CorSo) Claims Quality Assurance Head by executing the Claims QA program. Through your dedication to the highest technical standards in claim handling, you will support continuous improvement and delivery of technical excellence in CorSo Claims, reinforcing Claims as a critical competitive edge.
Reporting to the Head of Quality Assurance (QA), you will be responsible for:
•    performing 'check the checker' claims reviews (technical file reviews)
•    providing feedback on the quality of completed reviews (including reconciliation meetings)
•    conducting calibration training of Team Leads and Regional Reviewers
•    managing QA review system tasks 


In addition, you will support:
•    analysis of QA data and provide insights and improvement actions (lessons learned) to Claims
•    reporting of QA review results to global and regional claims management
•    targeted technical claim reviews 
•    maintenance of the global standard operating procedures (SOPs).
•    local teams in aligning local SOPs with the global SOPs
•    system improvements based on QA and technical claims requirements
•    continuous improvement of technical claims excellency through exchange with other claims functions such as recovery, vendor and counter fraud 
•    support the creation of technical training to enhance claims handling capabilities
•    development of QA Automation through data analytics and generative AI

 

About the Team:


•    The role is an individual contributor role in the Claims Quality Assurance team which is embedded within the larger Corporate Solutions Claims Governance & Performance Excellence team.
 

About You:


•    Bachelor degree (Masters preferred) 
•    Proficiency in English, Spanish/Portuguese
•    In-depth knowledge of technical claims handling
•    5 years related claim QA experience, ideally including leading audits preferred
•    Proficiency in data analysis, developing technical and process root cause issues
•    Experience in developing of performance improvement plans to respond to claims issues
•    Strong influencing skills and excellent customer service focus
•    Change management and corporate training expertise
•    Ability to communicate at the senior level
•    Excellent verbal and written communication skills
•    Advanced proficiency in Microsoft Excel and PowerPoint 
•    Prior LEAN methodology experience is an advantage

 

We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

 

About Swiss Re

 

Swiss Re is one of the world’s leading providers of reinsurance, insurance and other forms of insurance-based risk transfer, working to make the world more resilient. We anticipate and manage a wide variety of risks, from natural catastrophes and climate change to cybercrime. Combining experience with creative thinking and cutting-edge expertise, we create new opportunities and solutions for our clients. This is possible thanks to the collaboration of more than 14,000 employees across the world.

Our success depends on our ability to build an inclusive culture encouraging fresh perspectives and innovative thinking. We embrace a workplace where everyone has equal opportunities to thrive and develop professionally regardless of their age, gender, race, ethnicity, gender identity and/or expression, sexual orientation, physical or mental ability, skillset, thought or other characteristics. In our inclusive and flexible environment everyone can bring their authentic selves to work and their passion for sustainability.

 

 

Keywords:  
Reference Code: 130914 

 

 


Job Segment: Claims, Data Analyst, Change Management, Insurance, Data, Management