Claims Tpa Service

2 weeks ago

Auckland City, New Zealand Combined Insurance 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

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