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ClaimSorted is a Y Combinator-backed Third-Party Administrator (TPA) that manages insurance claims end-to-end for insurers using AI-enabled technology. The company has raised $16M+ and manages claims for 30+ insurers across $200M+ in insurance premiums.
You will join the Technical Claims Support Team as a QA & Authorisation Handler, serving as the final line of defence before claim settlements are approved. Your core responsibilities include:
• Reviewing claim settlements at the authorisation stage across all ClaimSorted products (Pet, Travel, Property, Auto, Gadget, and similar), independently assessing policy coverage, supporting evidence, and settlement calculations before making authorisation decisions.
• Conducting Quality Assurance reviews to ensure claims are handled accurately, fairly, and in line with policy, partner, and internal requirements.
• Identifying and preventing financial leakage, incorrect settlements, and other customer or financial risks through rigorous technical review.
• Providing clear, constructive, evidence-based feedback to Claims Handlers, confidently challenging decisions where required.
• Analyzing QA, authorisation, and leakage data to identify trends, recurring errors, training needs, and process or control gaps across products.
• Supporting improvements to claims processes, guidance, and controls based on findings and root-cause analysis.
• Maintaining accurate records of decisions and findings while managing and prioritising varied QA and authorisation workloads.
• Building and maintaining technical knowledge across all ClaimSorted product lines, partners, and processes.
• Collaborating across Claims Operations and the wider Technical Claims Support Team.
This role requires strong technical judgement, independent decision-making, and the ability to work confidently across multiple insurance products and processes. You will use data-driven analysis to identify systemic issues and drive operational improvements.
REQUIREMENTS:
• Minimum 2 years of experience completing claim authorisations within an insurance claims team, with responsibility for reviewing and making decisions on claim settlements.
• Minimum 3 years of experience working across two or more insurance product lines (Pet, Travel, Property, Auto, Gadget, or similar) in a claims role.
• Strong technical claims knowledge with confidence to independently review, challenge, and make evidence-based decisions.
• Excellent attention to detail, particularly when reviewing policy coverage, supporting evidence, and settlement calculations.
• Strong analytical skills with experience identifying financial leakage, trends, recurring errors, and process or control gaps.
• Ability to confidently provide clear, constructive feedback and explain the rationale behind decisions.
• Highly organised with ability to prioritise varied workloads based on risk, value, and urgency.
• Adaptable and comfortable learning new products, policy wordings, and processes in a fast-paced environment.
