Claims TPA Service & Conduct Lead

at  Combined Insurance

Chubb celebrates diversity by fostering an inclusive, flexible and equitable workplace. We support applications from all members of our community and equitable access to our employment opportunities. We are open to discussing workplace flexibility in all our vacancies, to ensure we can attract the best candidates and accommodate individual needs, differences, disabilities and working arrangements. Please let us know if you require any adjustments to the recruitment process so we can support you to present your best self.
Chubb is a world leader in insurance. With operations in 54 countries and territories, Chubb provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance and life insurance to a diverse group of clients. As an underwriting company, we assess, assume and manage risk with insight and discipline. We service and pay our claims fairly and promptly. The company is also defined by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength and local operations globally. Parent company Chubb Limited is listed on the New York Stock Exchange (NYSE: CB) and is a component of the S&P 500 index. Chubb maintains executive offices in Zurich, New York, London, Paris and other locations, and employs approximately 40,000 people worldwide. Additional information can be found at: www.chubb.com.

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