QA & Authorisation Handler

ClaimSorted is a Third-Party Administrator (TPA) that manages insurance claims end-to-end on behalf of insurers, in a ~$200B industry. We combine a high-performing claims team with an AI-enabled platform to deliver claims up to 3x faster, with better service and better economics for insurers.

We’re backed by Y Combinator, Atomico, and Eurazeo, have raised $16M+, and already manage claims for 30+ insurers across more than $200M in insurance premiums.

What we are looking for

We are looking for a confident, analytical and detail-focused QA & Authorisation Handler to join our Technical Claims Support Team.

You will provide a key technical control across our claims operation, completing Quality Assurance reviews and reviewing claim settlements at the authorisation stage.

As the final line of defence before a claim settlement is approved, you will be responsible for independently reviewing the claim, evidence, policy coverage and settlement calculation before making the decision to authorise, pass back or escalate.

This requires confidence and strong technical judgement. You must be comfortable making decisions, challenging claim assessments where something does not look right and clearly explaining the reasoning behind your decision.

The role goes beyond identifying individual errors. You will use findings from QA and authorisations to identify potential financial leakage, recurring handling issues, process and control gaps and emerging trends across the claims operation.

You will be comfortable using data to understand where issues are occurring, identify root causes and turn findings into practical improvements to processes, controls, guidance and training.

As ClaimSorted works across a range of insurance products and partners, you will need to be adaptable and confident moving between different products, policy wordings, processes and priorities while maintaining consistently high standards.

As part of the wider Technical Claims Support Team, you will also support other technical claims activities where required.

Responsibilities

• Review claim settlements at authorisation stage across all ClaimSorted products, acting as the final line of defence before payment is approved.

• Independently review policy coverage, supporting evidence and settlement calculations, making confident decisions to authorise, pass back or escalate.

• Complete Quality Assurance reviews across all products, ensuring claims are handled accurately, fairly and in line with policy, partner and internal requirements.

• Identify and prevent financial leakage, incorrect settlements and other customer or financial risks.

• Provide clear, constructive and evidence-based feedback to Claims Handlers, confidently challenging decisions where required.

• Use QA, authorisation and leakage data across products to identify trends, recurring errors, training needs and process or control gaps.

• Support improvements to claims processes, guidance and controls based on findings and root-cause analysis.

• Maintain accurate records of decisions and findings while effectively managing and prioritising QA and authorisation workloads.

• Build and maintain the technical knowledge required to work confidently across all ClaimSorted product lines, partners and processes.

• Work collaboratively across Claims Operations and the wider Technical Claims Support Team.

Skills and Experience Required

• +2 years experience completing claim authorisations within an insurance claims team is essential, with responsibility for reviewing and making decisions on claim settlements.

• +3 years experience working across two or more of the following product lines within a claims role: Pet, Travel, Property, Auto, Gadget or similar insurance products.

• Strong technical claims knowledge, with the 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.

• Able to confidently provide clear, constructive feedback and explain the rationale behind decisions.

• Highly organised and able to prioritise a varied workload based on risk, value and urgency.

• Adaptable and comfortable learning new products, policy wordings and processes in a fast-paced environment.

Mission

To act as a final line of defence within the claims settlement process, ensuring claim outcomes are accurate, fair and supported by policy and evidence before settlement is authorised.

The QA & Authorisation Handler will use strong technical judgement and independent decision-making to protect customer outcomes and financial performance, identifying errors, potential leakage and operational risks before they result in incorrect settlements.

Through Quality Assurance, data analysis and trend identification, the role will also identify wider knowledge, process and control gaps and help turn individual findings into sustainable improvements across Claims Operations.