Everest
Claims TPA Oversight Lead
How your CV stacks up
Upload your CV to see how well it fits this job role
?%
Title:
Claims TPA Oversight Lead
Company:
Everest Advisors (Uk), Ltd.
Job Category:
Claims
Job Description:
About Everest:
Everest is a global leader in risk management, rooted in a rich, 50+ year heritage of enabling businesses to survive and thrive, and economies to function and flourish. We are underwriters of risk, growth, progress and opportunity. We are a global team focused on disciplined capital allocation and long-term value creation for all stakeholders, who care deeply about our impact on communities and the wider world.
This is a great opportunity for someone currently in a Claims TPA oversight role, a Delegated Claims Analyst role or even a Claims Adjuster who wants to broaden their remit and move toward a more strategic, governance‑focused career path.
Role Purpose
As the Claims TPA Oversight Lead, you will act as a key conduit between the Everest Claims team and the Claims Vendor Management function. You will oversee the performance and technical quality of TPAs managing claims across multiple classes of business, with a particular focus on A&H, Property & Casualty claims.
You’ll help ensure TPAs and Coverholders meet regulatory expectations, follow Delegated Authority (DA) guidelines, and submit accurate bordereaux and above DA referrals on time. This includes working closely with internal stakeholders to ensure operational alignment and compliance.
In this role, you will support high technical standards, operational consistency, and continuous improvement across our International TPA and Coverholder panel.
Key Responsibilities
Technical Oversight & Quality Assurance
Develop and maintain technical oversight frameworks across all referenced lines of business Conduct comprehensive file reviews, QA assessments, and root‑cause analysis Provide technical guidance on complex claims, coverage interpretation, liability, and indemnity matters Monitor reserving accuracy and indemnity spend, flagging trends and anomalies Ensure TPAs remain within Delegated Authority levels and escalate issues where needed
TPA & Coverholder Performance Management
Reasons to use Rodeo
Start with a chat, not a search bar
Grad scheme, placement, apprenticeship? Not sure what you want yet — that's fine. Your agent talks it through with you and turns "I have no idea" into a shortlist.
It searches the market for you
Every day your agent scans the market matching roles against what actually matters to you, not just keywords on a CV.
Only hits
No noise. No "maybe this fits." Just roles with a clear explanation of why they're right — and where to focus when applying.
Act as the link between the Claims team and Claims Vendor Management, ensuring a cohesive approach to TPA and Coverholder oversight Support 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 Identify performance gaps and assist with action plans and ongoing tracking Support onboarding, transition, and exit processes for TPAs and Coverholders
Data, MI & Reporting
Analyse claims MI to identify trends, risks, performance issues, and leakage Prepare clear, effective reporting on oversight activities for senior stakeholders Liaise with the Global Claims QA team where appropriate
Stakeholder & Cross‑Functional Collaboration
Work closely with Underwriting, Claims Quality Assurance, Legal, Actuarial, Finance, and Claims Operations Act as an escalation point for complaints, and technical challenges involving TPAs Support internal and external audit requests relating to TPA oversight and quality assurance
Essential
Skills, Experience & Competencies
Strong claims experience across relevant classes, ideally across both insurer and TPA environments Experience in technical oversight, performance monitoring, or audit Strong stakeholder engagement and influencing capability Ability to interpret data and translate insights into meaningful action
Desirable
Experience with international TPA networks or cross‑border claims Understanding of Lloyd’s, Wholesale, or London Market operating models Experience in process improvement or project delivery Familiarity with claims platforms (Guidewire, ECF, IMR)
Qualifications
Dip CII / ACII preferred Degree or equivalent experience in insurance, legal, or risk disciplines
Core Competencies
Technical claims expertise across A&H and P&C Strong oversight and governance mindset Analytical and detail‑focused Collaborative and able to work cross‑functionally Sound decision‑making skills Customer‑focused with a commitment to fair outcomes Strategic, solutions‑oriented thinking Commercial awareness Ability to work effectively in a matrixed environment Strong communication skills, both written and verbal
Get help with your application
Your very own career expert that helps elevate your application to the next level.
If you’re passionate about improving claims performance, strengthening vendor relationships, and ensuring exceptional customer outcomes, we’d love to hear from you.
What if I don’t meet every requirement? At Everest we are dedicated to building an inclusive and authentic workplace. So, if you are excited about this role but your past experience doesn’t align perfectly with every element in the job description, we still encourage you to apply. You may be just the right candidate for this or other roles. Please let us know if you need any accommodations throughout the application or interview process.
Our Culture
At Everest, our purpose is to provide the world with protection. We help clients and businesses thrive, fuel global economies, and create sustainable value for our colleagues, shareholders and the communities that we serve. We also pride ourselves on having a unique and inclusive culture which is driven by a unified set of values and behaviors. Click here to learn more about our culture.
Our Values are the guiding principles that inform our decisions, actions and behaviors. They are an expression of our culture and an integral part of how we work: Talent. Thoughtful assumption of risk. Execution. Efficiency. Humility. Leadership. Collaboration. Inclusion and Belonging. Our Colleague Behaviors define how we operate and interact with each other no matter our location, level or function: Respect everyone. Pursue better. Lead by example. Own our outcomes. Win together.
All colleagues are held accountable to upholding and supporting our values and behaviors across the company. This includes day to day interactions with fellow colleagues, and the global communities we serve.
Type:
Regular
Time Type:
Full time
Primary Location:
London
Additional Locations:
Privacy Notice | Everest (everestglobal.com)
“It took my CV and asked me questions relevant to understanding what kind of jobs to suggest for me. Suggestions were almost perfect. Jobs were exactly what I’ve been looking for.”
Jessica, London
Skills
Location