Claims TPA Oversight Lead

Claims TPA Oversight Lead focuses on maintain technical oversight frameworks across all referenced lines of business.

What the role involves

• Maintain technical oversight frameworks across all referenced lines of business.
• Provide technical guidance on complex claims, coverage interpretation, liability, and indemnity matters.
• Monitoring reserving accuracy and indemnity spend, flagging trends and anomalies.
• Ensure TPAs remain within Delegated Authority levels and escalate issues where needed.
• Supporting TPA performance reviews, scorecards, governance meetings, and service delivery assessments.
• Work closely with the Claims Performance Manager (UK & Ireland) and the Vendor Management team to ensure timely bordereaux submissions and accurate referral handling.

Skills and requirements

• Strong claims experience across relevant classes, ideally across both insurer and TPA environments.
• Experience in technical oversight, performance monitoring, or audit.
• Experience with international TPA networks or cross‑border claims.
• Experience in process improvement or project delivery.