Reinsurance Claims Auditor

This is a fully remote position, open to applicants in United States.

📋 Description

• Manage multiple audit engagements and their lifecycles concurrently.

• Supervise the complete audit process by gathering data from cedants or TPAs regarding claims handling structures and requesting relevant information in advance of the audit.

• Conduct audits of Cedants, TPAs, and Client Claims Teams to ensure compliance with contractual agreements, service level agreements (SLAs), as well as industry standards and regulatory requirements.

• Examine pre-audit questionnaire (PAQ) responses and necessary documentation; formulate follow-up questions and inquiries as required.

• Assess direct and/or ceded claims submissions for accuracy, timeliness, and adherence to reinsurance contract terms (including treaty and facultative, when applicable).

• Oversee communication, preparatory work, onsite/remote activities, wrap-up processes, meetings, and post-audit/reporting functions.

• Analyze claims handling practices through structured audit testing and sampling to detect systemic risks, contract term deviations, and exposure trends.

• Review any liability or coverage decisions to validate appropriate claims handling actions.

• Create clear and defensible audit reports and executive summaries; assist in client read-outs and address follow-up inquiries regarding findings and recommendations.

• Coordinate with the Audit Administrator concerning audit preparations and the readiness of reinsurers/TPAs.

⛳️ Requirements

• A minimum of 5 years of experience in (re)insurance claims.

• Proven experience in auditing or conducting quality assurance reviews.

• Strong history of developing business and client relationships.

• Bachelor’s degree in business administration or a related field.

• One or more industry designations such as Chartered Property Casualty Underwriter (CPCU), Associate in Claims (AIC), Associate in Reinsurance (ARE), etc.

• Comprehensive working knowledge of reinsurance claims.

• A highly organized and analytical mindset along with strong quantitative problem-solving abilities.

• Exceptional written and verbal communication skills.

• Detail-oriented with outstanding organizational and planning capabilities.

• Ability to work both independently and collaboratively, demonstrating initiative is essential.

• Willingness to travel within the USA up to 10% of the time.

🏝️ Benefits

• Engaging client-facing role.

• Opportunities for travel.

• Potential for growth and maintenance of client relationships.