Claims Peer Reviewer

2 months ago

Gloucester, Gloucestershire, United Kingdom Pro Insurance Solutions Ltd Full time
Job Summary

We are seeking a highly skilled Claims Peer Reviewer to join our Audit and Advisory team at Pro Insurance Solutions Ltd.

This is an exciting opportunity for a professional with a strong background in insurance claims adjusting and report writing to lead and complete claims peer reviews.

Key Responsibilities
  • Claims Peer Review
    • Undertake file reviews, build and maintain client relationships, and report on findings.
    • Ensure high-quality reports are generated that meet client requirements.
    • Liaise with clients to report any concerns, progress updates, and compile work plans.
    • Write reports and appendices, and prepare initial summary assessments of findings for clients.
    • Issue reports and invoices.
  • Support Advisory Projects
    • Provide subject matter expertise (SME) support to Advisory projects, such as Due Diligence.
  • TPA Audits
    • Support TPA audits, including file testing.
  • Liaise with Stakeholders
    • Liaise with all stakeholders to ensure timely delivery of projects and audits within agreed budgets.
  • Review and Analysis
    • Review specific documentation provided by the TPA/client to understand the focus of the audit/peer review.
    • Review claims files and populate testing templates.
  • Report Writing
    • Write reports to summarize findings or check (quality control) reports to ensure adherence to the scope.
Requirements
  • Analytical Skills
    • Analytical skills to review reports, identify issues, and assess their importance.
  • Communication Skills
    • Effective communication skills to communicate with both internal and external stakeholders.
  • Time Management
    • Ability to manage time, meet deadlines, and prioritize tasks.
  • Teamwork
    • Teamwork skills to work collaboratively with colleagues.
  • Computer Skills
    • Strong computer skills, including good working knowledge of MS Office, intermediate Excel, Word, and PowerPoint skills.
  • Insurance Experience
    • Experience in claims adjusting and report writing.
  • Outcome Focus
    • Outcome-focused, self-motivated, confident, and enthusiastic.
  • Diplomatic Skills
    • Diplomatic, cooperative, and collaborative approach.
  • Assertiveness
    • Assertive, persuasive, and resilient.

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