Claims Peer Reviewer

We have an exciting internal opportunity for someone to join the Audit and Advisory team as a Claims Peer Reviewer.

Using a combination of your insurance knowledge, communication and report writing skills you will lead and complete claims peer reviews, working closely with the client and the Audit and

Advisory team you will complete audits and report to the client on your findings.

Pro operates a hybrid working model, with time split between working from one of our UK offices in Gloucester or London as required.

Key responsibilities / tasks may include:

• Undertake / Lead claims peer reviews – undertaking file reviews, building and maintaining client relationships and reporting
• Ensure high quality reports are generated that meet the client requirements
• Liaising with clients to report any concerns, progress updates; compile work plans; undertake on-site work including wrap up meetings
• Writing reports / appendices; If required (or if significant issues are identified), prepare initial summary assessment of findings for client.
• Issue report & invoice
• Provide SME support to Advisory projects e.g. Due Diligence
• Support TPA audits
• File testing
• Liaise with all stakeholders to ensure timely delivery of project / audit within agreed budgets
• Review specific
• documentation provided by the TPA / client to understand focus of audit / peer review
• claims files and populate testing templates
• Write report to summarise findings or check (quality control) reports to ensure adherence to the scope

Knowledge, Skills and Experience

• Analytical, able to review reports, identify issues and assess their importance
• Able to communicate effectively both verbally and in writing with both internal and external stakeholders and to successfully manage these relationships
• The ability to manage time, meet deadlines and prioritise
• Team worker as well as able to work on own initiative
• Meticulous, precise, thorough, good at record keeping
• Strong computer skills – good working knowledge of MS Office, intermediate excel, word and powerpoint skills, knowledge of access advantageous
• Experience of Claims adjusting
• Experience of report writing
• Outcome focused, self-motivated, confident and enthusiastic
• Diplomatic, cooperative and collaborative in approach
• Assertive, persuasive, resilience

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The Company

Pro is a specialist outsourcing and consulting company focused solely on the insurance and reinsurance industries.

We work with clients to identify changes needed to improve their business processes, minimise operating overheads and implement the controls required to meet new regulations, delivering tailored solutions to meet clients’ needs.

Our UK offices are in Gloucester, Glasgow, Liverpool, Horsham and central London. We are also a global company with offices in the United States, Cologne and Unna (Germany) and Argentina. We also operate a hybrid working model so you can work at home and in the office.

We provide expert support in the areas of underwriting, claims management, financial and technical accounting, and risk and auditing, utilising the best technology available on the market and adopting a proactive approach.