Advisor, Quality Assurance

Definity Insurance Company • Waterloo, ON

1d • Hybrid

About The Position

The Claims Quality Advisor will provide senior advisory quality assurance (QA) insight by framing findings, implications, and risks within and across Lines of Business to support decision‑making and QA program credibility. Shapes the application of a technical claims quality program within one or more areas of the claims business. This Line 1 defence mechanism for Claims ensures our claims handlers and leaders are meeting customer expectations, ensuring case reserves are timely and accurate, managing claims according to regulatory requirements, and adhering to file handling practices and SLA's to Definity standards. The Claims QA Advisor translates QA findings into clear insight, implications, and trade‑offs to enable sound decision‑making by QA and claims management. The role anticipates business response, distinguishes systemic risk from isolated issues, and shapes how QA insight should be understood, without owning actions, prioritization, or escalation outcomes. In collaboration with the Claims QA Manager, the Claims QA Advisor contributes to quality control, technical training, and trending analysis by incorporating data analysis to measure and monitor adherence to regulatory and company standards of the Claims Services portfolio. This includes quality assurance oversight of business line specific vendor programs, monitoring emerging risks to strengthen the organization's ability to identify, assess, mitigate, govern and report quality risks. The Claims QA Advisor is responsible for tracking and monitoring claims issues and associated mitigation plans, assessing effectiveness, and supporting the ongoing improvement and monitoring of the Claims Quality Assurance methodology and framework. The role serves as the primary facilitator of line of business calibration and new hire orientation and is accountable for providing technical support, training, direction and guidance for claims QA-related ClaimsMonitor Services, including profile management, deployment, reconsideration requests, and audit managing. Maintaining current knowledge of LOB-related regulatory updates and industry trends to support the focused area of claims is a necessary requirement.

Requirements

• University Degree/College Diploma or an appropriate level of experience
• 10+ years of progressive claims handling experience including significant hands‑on claims handling experience within one or more lines of business
• Demonstrated experience providing expert QA, audit, or quality assurance guidance, including framing findings, risks, and implications for senior QA and Claims stakeholders
• Experience applying judgment to complex or ambiguous claim handling issues and distinguishing systemic risk from isolated findings
• Experience supporting audit, quality assurance, regulatory compliance, risk management, or control‑based review activities within one or more claims lines of business
• Experience engaging with people leaders and senior stakeholders through credibility, influence, and professional judgment, without reliance on positional authority
• Excellent analytical, written, and verbal communication skills, with the ability to frame complex QA findings and implications clearly for diverse audiences
• Ability to synthesize information, apply expert judgment, and translate QA insight into meaningful, decision‑supporting guidance
• Strong organizational and problem‑solving skills, with the ability to balance multiple priorities across lines of business
• Ability to influence and collaborate through expertise, credibility, and trust, fostering strong stakeholder relationships and QA program confidence

Nice To Haves

• Interested in this role, but don’t meet every requirement? We encourage you to apply! We know from experience that a candidate doesn’t need 100% of the qualifications listed to bring incredible value to our team. We’re actively seeking diverse backgrounds and perspectives to help us make insurance better. At Definity, inclusion, diversity, and equity aren’t just “nice to have” — they’re essential to our success.

Responsibilities

• Execute targeted and complex claim file reviews within one or more areas of the claims business, applying expert judgment to interpret QA standards in high‑risk, ambiguous, or precedent‑setting scenarios.
• Use file‑level reviews to validate trends, test hypotheses, and inform broader analysis, calibration, and advisory activities.
• Lead interpretive analysis and reporting by synthesizing technical file review results, trends, and emerging risks across lines of business.
• Translate findings into clear insight, implications, and trade‑offs that explain why issues occur and distinguish systemic risk from isolated findings.
• Shape key QA messages, enhance reporting approaches, and provide expert input to support informed discussion and decision‑making by QA and Claims management.
• Serve as the primary facilitator of calibration activities to ensure consistent interpretation and application of QA standards across reviewers, lines of business, and vendors.
• Support resolution of interpretation differences, provide expert guidance on standard application, and strengthen program‑wide QA consistency and reliability.
• Lead or contribute to targeted initiatives and special projects that strengthen QA methodology, tools, governance practices, or analytical capabilities.
• Provide subject‑matter expertise for focused assessments, deep-dive reviews, emerging risk analysis, or program enhancements as required.

Benefits

• Hybrid work schedule for most roles
• Company share ownership program
• Incentive Program - Eligible employees may participate in various incentive plans which are paid out at the discretion of the company and subject to individual and company performance.
• Pension and savings programs, with company-matched RRSP contributions
• Paid volunteer days and company matching on charitable donations
• Educational resources, tuition assistance, and paid time off to study for exams
• Focus on inclusion with employee groups, support for gender affirmation surgery, access to BIPOC counsellors, access to programs for working parents
• Wellness and recognition programs
• Discounts on products and services

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: Associate degree