Travel Claims Quality Assurance Executive

This is an exciting opportunity to join us as a Quality Assurance Executive. Reporting to the Travel Claims Manager, you will oversee a broad range of quality assurance reviews, audits, along with monitoring and checking of our risk control framework for the Travel Claims operation, including our in-house Claims Team and third-party Medical Assistance supplier (CEGA).

We are looking for someone who has a keen eye for detail and who sets high standards when it comes to the way things are done. You need to be good at building positive relationships with a wide variety of stakeholders and be effective at developing and encouraging others around you to raise the bar on quality. The key focus will be to identify if claims are being handled correctly and in line with agreed processes and procedures, ensure we are delivering fair customer outcomes, managing costs effectively, ensuring efficient processing of claims and good control of our risks.

The types of reviews you will undertake as part of the role will include:

- Reviews of claims at all stages of the lifecycle assessing decision making, customer service, quality, and cost control, working closely with the Team Managers to drive continuous improvement of our Claims Handlers
- Leakage reviews to establish if claims are being handled and settled correctly, in accordance with policy terms and conditions, claims processes and policy limits
- Third-party supplier reviews to ensure adherence to contract terms, quality of claims handling, cost containment and fair customer outcomes
- Ad-hoc reviews and audits of key processes and procedures, to ensure they are effectively working such as fraud, recoveries, complaint handling, customer feedback etc
- Regular monitoring and checking of our risk control framework

This is an exciting opportunity to help support a culture of continuous improvement and to ensure we always challenge the status quo.

You will be required to use your initiative and implement ideas aimed at improving performance, which consider the customer, our claims handlers and the business needs collectively. You will have set targets and deadlines to achieve each month, as the results of quality assurance and audits will be used for incentive, CRMI and other reporting measures.

You will be required to identify compliance and quality training needs and help design training where appropriate, ensure the department remains up to date with new governance which is introduced (considering not just customer outcomes for the general customer base but also the needs of vulnerable customers), be pro-active in identifying common breaches /poor customer feedback, and suggesting and implementing solutions to improve.

**Your main duties will include**:

- Undertake a variety of reviews/audits of internal claims operation and external suppliers against an agreed scope
- Work with your Manager to define the requirements of future reviews and checks across operational processes
- Prepare reports and insights to help identify good practices or areas for improvement
- Identify opportunities for improvements to processes/controls that ensure that the operation remains fit for purpose in the context of governance and oversight
- Ensure that we have an efficient and robust remediation process in place and a control to manage it
- Work closely with handlers who require additional support/training/coaching/development
- Provide detailed and constructive feedback via the quality assurance reviewing forms
- Help drive continuous improvement by spotting training needs, knowledge gaps and process/procedural refinement
- Update and maintain quality assurance results and records
- Ensure that process, procedure, and training documents are regularly reviewed, maintained, and updated
- Actively participate in cost control activities, such as leakage audits and recovery opportunities
- Ensure that our quality assurance strategy remains up to date and in line with regulatory guidelines
- Have regular oversight of our risks and controls to ensure they are being managed effectively

**The experience and skills required are**:

- Must have a strong appetite for improving the customer journey and rectifying unfair customer outcomes
- Must be confident and able to communicate clearly to all staff members from frontline staff to senior stakeholders
- A strong work ethic and desire to support and develop staff
- A good understanding of Microsoft packages
- Strong attention to detail and analytical skills
- Confident decision-making skills
- Pro-active, organised, and able to manage their time effectively and take initiative
- A great can-do attitude to support the business in change whilst achieving good customer outcomes
- Experience of reviewing/monitoring claims processes preferred but not essential
- Experience of auditing and report writing preferred but not essential
- Experience of understanding risk and controls preferred but not essential

**About Admiral**

Admiral Group is a