Claims Tpa Service

5 months ago

Auckland City, New Zealand Chubb Full time

**Your Role**:
Chubb partners (outsources) with external claims management organizations or TPA (Third Party Administrators) to assist in managing claims start to finish in specific situations. NZ Claims TPA Lead, reporting into NZ Claims Manager, manage and facilitate Chubb Claims TPA outsourcing relationships.
The role requires regular engagement with Chubb internal stakeholders, Chubb Claims team and TPAs to ensure smooth functioning of TPAs while maintaining rigor in claims service Chubb is known for by assisting & resolving blockers.
The NZ Claims TPA Lead may participate in the onboarding, insourcing &/or transitioning of TPA’s onto Chubb specific system, processes and guidelines.

**Your Responsibilities**:

- Ensuring that Chubb has appropriate oversight and supervision of Third-Party Administrators, ensuring that legitimate claims are paid in accordance with policy conditions by providing technical expertise and leadership.
- Ensure compliance with Chubb TPA framework - and overall Company Policies and procedures are implemented and achieved effectively by the TPA.
Monitor TPA operational reports and provide information regarding their compliance to legal and regulatory requirements.
- Ensuring that Chubb remains fully informed and receptive to change by monitoring industry/market and legal trends and providing recommendations for change strategies.
- Engage and maintain relationships with Chubb and TPAs partners, including:

- Undertaking performance monitoring to ensure service delivered in accordance with Chubb best practice
- Review and determine appropriate delegated authority limits for TPAs
- Review and manage TPA for their performance, standards and efficiency
- Identify opportunities to streamline/improve operational TPA processes
- Conduct systems and process trainings to Claims TPA staff and act as first line of contact for TPA day-to-day queries, issues and any other requests
- Participate and drive regular claims TPA audits, present findings and ensure actions are resolved within a timely manner
- Review, document and maintain various artefacts associated with TPA’s, including compliance, reporting, operational including bordereau management and best practice documents
- Maintain issue logs and records of discussions and training to resolve any impediments
- Minimum 3 years of experience in General Insurance Claims, and lifecycle of claim is must
- Experience in Property, travel, home or contents claims management is preferred
- Business acumen skills and understanding of the fundamental components of a claims department’s operation and its associated data
- Should have good written and verbal communication skills - Ability to interact with senior stakeholders internally and externally
- Knowledge of NZ Fair Insurance Code and other insurance regulatory, risk and compliance are desired
- Able to articulate Insurance business flows into process flows, system requirements and data flows
- Stakeholder Management: Expectation management and Relationship management experience preferred
- Able to present in front of a group - external/internal, for example training delivery
- Hands-on experience with office productivity tools and/or workflow management is a requirement
Excel - Use of functions, Pivots, Charts, Data analysis;
Word, PowerPoint, Visio - Basic flow, swim lanes, system prototypes etc.

We offer you the opportunity to work as part of a dynamic and agile environment where continuous development is encouraged throughout your career, both locally and globally. We also offer a flexible working approach via our “My One Thing” initiative, education assistance, dress for your day every Friday, promotion of health and wellbeing (including discounted health insurance, daily breakfast and fresh fruit), and the option to enrol into the Chubb Limited discounted stock purchasing scheme.

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