* **Compliance**: ensuring that the control environment meets the high standards established by the various regulations that govern the Claims role. These various regulations pertain to a wide array of control frameworks ranging from internal best practice guidelines to regulatory requirements. Properly managing and enhancing this control framework is the basis for empowering the various claims teams.* **Vendor Management**: Both local regulation, and internal guidelines establish that all Claims vendors must have a contract. Some of these contracts are subject to a very specific local regulation (REPSE) and require intensive follow up in terms of requirements that must be met. Compliance with this requirement determines whether the usage of such vendors can be registered as tax deductible.* **First notice of loss (FNOL):** properly managing this activity which creates capacity within the technical handling teams by absorbing this activity (which is of a low variability in nature) and seeks to find solutions for efficiency and automation.* **Business Analytics:** properly managing the exploitation of data to the benefit of better assessing the efficiency of the operation and allowing for better decisions by claims management. Ensuring that the flow of data is adequate by ensuring that adequacy of the source of data.* **Process evaluation and Continuous Improvement**: proper assessment of the “as is” status of the operation will eventually lead to determining the correct “target” KPI ́s, processes and controls. This analysis will imply the need for improvement projects and initiatives that need to be led and pushed by claims management through the support of this role.* Deep understanding of the insurance industry and the claims process. Understanding of the context and roles of each of the main types of claims vendors (i.e. adjusters, lawyers, consultants, salvage companies, recovery agents, etc.).* Basic understanding of the claims function and how it relates to the different areas of an insurance company (i.e. UW, operations, audit, sales, etc.)* Design, understand, and map complex processes; manage apps/tools to present quickly and efficiently these to internal and external stakeholders.* Good practices to map, manage and audit risks inherent to the documented processes of the claims department.* Design, understand and create underlying policies and procedures; manage process to accurately describe operational realities into documented policies and procedures.* Management, enhancement, maintenance, and training of all aspects of the anti-money laundry framework.* Best practices related to security information and data protection activities.* Good vendor management practices and local regulatory requirements.* Quality statistical control tools and principles.* Industrial Engineering principles in terms of Continuous Improvement, Total Quality Control, Lean Processes, Kaizen, etc.* Data management software (i.e. Excel) and business intelligence solutions (i.e. Power BI)* Partnering with line managers and handlers to map operational processes to assess these from a compliance and risk management perspective. This is a continuous monitoring key in a constantly evolving context (fiscal, regulatory, etc.).* Once mapped, conduct ongoing preventive assessments, reviews, and analysis to provide constructive feedback to line managers which will ensure a robust operation is in place.* Being an in-house claims resource with market information regarding key compliance topics like anti-money laundry guidelines, to assess for example how to onboard new complex accounts.* Supporting the Head of Claims to comply with internal and external local regulation to ensure that a pool of +500 suppliers meet international standards as well as local regulation. Ensure that an appropriate evaluation of the performance of key vendors is effective and timely.* Effectively managing individuals that perform manual data entries into the claims system (FNOL) in a cost-effective manner and with the appropriate data quality. Ensuring that the usage of human resources is effectively combined with the usage of automation and RPA technology.* Understand the data structure and system platform. Develop plans to provide analytics to the different stakeholders of the insurance company (within and outside of Claims). Develop plans and solutions to guarantee the accuracy and consistency of the data provided to evaluate the operation and develop action plans.* Design and lead data driven solutions to address operational problems and deficiencies related to process, human and/or systemic nature. Align these evaluations with the overall value-added initiative of the company. Provide insights and information to management that can be taken to market and allow for AIG to differentiate from its competitors in the insurance market.* Academic background: Industrial Engineering, Finance, Accounting or Business administration.* Key soft skills of the position: balance between high and stringent controls and ever evolving needs of operational reality.* Incumbent needs to be a team player that needs to be recognized in the team as effective partner.* Other key skills are good communication, powerful synthesis, situational leadership.- Experience: * +5 years in Operations, Process, Auditing and/or Quality Control activities in banking, insurance, or financial service industries. * Specialization or experience in Audit related positions is a plus. * Understanding and/or participation in compliance activities (i.e. Solvency II, governance committees, etc.) is a plus. * Experience in quality control projects is a plus. * Exposure to continuous improvement projects like statistical quality control projects or system implementation initiatives. * Process mapping. * Management of Excel, Power BI, etc.#J-18808-Ljbffr
Mexico Claims Compliance, Performance & Operations Manager
AMERICAN INTERNATIONAL GROUP
distrito federal, distrito federal
Publicado hace 7 días
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