Claims Operations Analyst

The Delegated Claims Specialist is responsible for the oversight, governance, onboarding, monitoring and performance management of Delegated Claims Administrators (DCAs), Third Party Administrators (TPAs) and Coverholders with delegated claims handling authority. The role supports the organisation's delegated claims framework by ensuring that delegated claims arrangements operate effectively and comply with internal claims management guidelines, regulatory requirements, conduct risk expectations and contractual obligations. The Delegated Claims Specialist acts as a key liaison between Claims, Underwriting, Compliance, Legal, Finance and external claims handling partners. Key Responsibilities:

• Support the governance and oversight of delegated claims arrangements.
• Maintain accurate records of DCA authorities, contracts, onboarding documentation and relationship ownership.
• Ensure delegated claims handlers operate within approved authority limits and contractual terms.
• Monitor claims handling activities performed by DCAs and TPAs to ensure adherence to agreed service standards.
• Escalate claims, operational, compliance or conduct concerns to Claims Management as appropriate.
• Coordinate end-to-end onboarding activities for new DCAs and TPAs.
• Facilitate due diligence reviews involving Compliance, Finance, Legal and operational stakeholders.
• Review completed onboarding questionnaires, policies, procedures and supporting documentation.
• Conduct periodic reviews of delegated claims handlers against contractual and operational requirements.
• Review Management Information (MI), bordereaux, audit findings, complaints data, leakage trends and service metrics.
• Track remediation actions arising from audits, quality reviews and operational assessments.
• Support ongoing monitoring activities throughout the DCA lifecycle.
• Coordinate delegated claims audits and file reviews.
• Validate compliance with claims handling authorities, reserving standards, settlement authority limits and reporting requirements.
• Monitor closure of audit findings and corrective action plans.
• Ensure delegated claims arrangements comply with applicable internal policies, Lloyd's requirements, FCA expectations and company governance standards.
• Support governance forums and committees through the provision of reporting and analysis.
• Maintain accurate records of approvals, contracts, oversight reviews and monitoring activities.
• Build effective relationships with DCAs, TPAs, Coverholders, Underwriters, Compliance, Finance, Legal and Operations teams.
• Act as a primary operational contact for delegated claims queries.