Claims adjuster Accident and Health/TPA

Main roles & responsibilities

• CBRA (10% to 20%): coordinating cybersecurity questionnaire with TPA Governance Compliance & Risk Officer & the Global Cybersecurity team in charge of the assessment; including preparation meetings with the TPAs & remediation plan follow up when applicable
• Contracts (10% to 20%): negotiating contracts handling agreement with the TPAs in coordination with the Legal, UW, Claims teams + subject matter experts if needed (sanctions, fraud&recovery) – negotiating amendments to the contracts against updates in regulation, law, AIG policies, changes in the claims delegation authorities or in the claims guidelines
• Audits (10% to 20%): leading the operational/compliance TPAs’ audits / coordinating the technical audits performed either by the local Claims team or by the Global Quality Assurance team. Recommendations follow up when required. Contribution to build the yearly audit plan f...