QA Supervisor (TPA Insurance)
About this position
Responsibilities
• Conduct regular audits of claim files to ensure compliance with company guidelines, insurance policies, and regulatory requirements.
• Develop and implement QA procedures for claims processing to ensure accuracy, consistency, and timeliness in the settlement of claims.
• Monitor and evaluate the performance of the claims team through KPIs such as processing accuracy, customer satisfaction, and turnaround time. Provide feedback and training where necessary.
• Ensure all claims processing activities adhere to regulatory standards, mitigating any potential risks through early detection of compliance gaps.
• Analyze QA reports and provide insights to senior management on claims trends, areas of concern, and improvement opportunities.
• Train and mentor the claims team on QA standards, ensuring they are up to date with policies, procedures, and best practices.
• Collaborate with claims adjusters, customer service, and IT teams to streamline the claims handling process and implement new technologies or procedures to enhance efficiency.
• Monitor customer feedback related to claims processes, identify recurring issues, and recommend solutions to improve service quality.
• Work with the claims and customer service teams to investigate and resolve complex claims issues or complaints, ensuring timely and satisfactory resolutions.
Requirements
• 3-5 years of experience in claims handling, quality assurance, or supervision, preferably in a TPA or insurance company.
• Bachelor’s degree in insurance, business administration, or a related field.
• Strong knowledge of claims processing and TPA insurance operations.
• Strong written and spoken English and Bahasa Indonesia.
• Familiarity with local and international insurance regulations and compliance standards.