Claims QA & Authorisation Specialist

Remote Worker LTD.; United States; Remote; USD 75,000 - 115,000; Full time

Benefits offered by this job

Health insurance

Pension contributions

28 days annual leave

Quarterly performance bonus up to 15%

Equity participation

Job summary

ClaimSorted is seeking a QA & Authorisation Handler to join the Technical Claims Support Team. You will: review settlements at the authorisation stage, verify policy coverage and evidence, and authorise, pass back or elevate decisions.

You will also perform QA reviews across products, identify leakage, and drive process improvements based on data. The role requires strong technical judgment, the ability to explain decisions, and comfort with fast-paced, cross-product work across insurers and

Qualifications

• +2 years experience completing claim authorisations within an insurance claims team is essential.
• +3 years experience across two or more product lines (Pet, Travel, Property, Auto, Gadget or similar).
• Strong technical claims knowledge with independent decision-making.
• Excellent attention to detail when reviewing policy, evidence and settlements.

Responsibilities

• Review claim settlements at authorisation stage across all ClaimSorted products, as final defence before payment.
• Independently review policy coverage, supporting evidence and settlement calculations, and authorise/pass back/elevate as needed.
• Complete Quality Assurance reviews across all products, ensuring fair, accurate handling per policy and requirements.
• Identify and prevent financial leakage, incorrect settlements and other risks.
• Provide clear, constructive feedback to Claims Handlers and challenge decisions when required.
• Use QA and leakage data to identify trends, errors, training needs and process gaps.
• Support improvements to claims processes, guidance and controls based on findings.
• Maintain records of decisions and findings while prioritising workloads.
• Build knowledge across all ClaimSorted product lines, partners and processes.
• Work with Claims Operations and the Technical Claims Support Team.

Skills

Claims authorisation

Insurance claims

Data analysis

Attention to detail

Analytical thinking

Decision making

Learning new products

Job description

ClaimSorted is seeking a QA & Authorisation Handler to join the Technical Claims Support Team. You will: review settlements at the authorisation stage, verify policy coverage and evidence, and authorise, pass back or elevate decisions.

You will also perform QA reviews across products, identify leakage, and drive process improvements based on data. The role requires strong technical judgment, the ability to explain decisions, and comfort with fast-paced, cross-product work across insurers and