Business Controls Specialist Ontario

Next Horizon is here. Fueled by investments in talent and technology, our bold strategy to transform is nearly complete.

At Gore Mutual, we’ve always set ourselves apart as a modern mutual that does good. Now, we’re proudly building on that legacy to transform our company—and our industry—for the better.

Our path forward sharpens our focus on business performance, driven by leading technology, innovation and an agile, high‑performing culture. With Gore Mutual and Beneva announcing their intent to merge in 2026, we’ll be uniting two well‑established, financially strong, and trusted brands to become the strongest mutual insurer in Canada, ensuring Canadians have purpose‑driven insurance options for generations to come. Come join us.

The role of the Business Controls Specialist exists to lead the implementation and execution of the quality assurance program, including completing file reviews for all lines of business, conducting testing on internal practices, creating and maintaining all processes and procedures and supporting the Manager Claims Business Controls to ensure Claims is adhering to the highest standards and identifying areas of improvement.

This role will obtain both qualitative and quantitative metrics that can be provided to the Manager Claims Business Controls to identify areas of improvement.

Leading Claims Audit and Analysis

• Conduct thorough Quality Assurance audits of claims, ensuring accuracy and compliance with processes.
• Analyze audit outcomes to identify improvement areas and potential risks.
• Collaborate with the Manager Claims Business Controls to implement audit recommendations and refine processes.

Monitoring and testing internal controls & supporting external audits

• Support the Manager Claims Business Controls to monitor and test internal controls for adherence on a regular basis.
• Supporting the operations to ensure all controls are being met.
• Represent Claims during internal / external audit and provide direction/feedback required.
• Provide reporting on the operations’ performance as it relates to internal control testing.
• Continuously report on these metrics, offering insights and analysis.

Providing Inputs on Claims Processing and Procedures

• Analyze current claims processes, suggesting improvements based on data‑driven insights.
• Participate in the updating and enhancement of claims handling procedures.
• Collaborate with the Claims Business Controls team to create and update procedures and processes related to initiatives impacting Claims.
• Collaborate with the Claims Business Controls Manager to track the Key Risk Indicators monthly.
• Support ERM with the updating of the KRIs monthly as required.
• Engagement in all risk and compliance activities as directed by the Claims Business Controls Manager.
• Stay up to date on industry’s best practices and regulatory changes that impact the Claims Operations.

Stakeholder Communication and Project Support

• Effectively communicate analytical findings and recommendations to a diverse range of stakeholders.
• Engage in ongoing professional development to remain abreast of industry trends and advancements in data analysis and claims management.
• Facilitate workshops and training sessions for supervisors, emphasizing the importance of adhering to audit and oversight requirements.

• Post secondary education, Undergraduate Degree.
• IICRC certifications in water remediation and applied structural drying certification including WRT, ASF, AMRT, and FSRT considered an asset.
• ICAR, CHIEF or other Automotive certifications considered an asset.
• 3-5 years work relevant work experience.
• 5+ years of multi Claims line experience considered an asset.
• 2-3 years working as a claims Team Leader considered an asset.
• Experience in audit, risk management, regulatory compliance, processes & controls considered an asset.
• Strong understanding of business operations and internal policies/procedures.
• Data Analysis – analysing and interpreting data.
• Audit and oversight– ability to develop and maintain tactics to measure adherence to internal controls.
• Strategic thinking – capable of aligning performance analysis with the overall business strategy.
• Technical…