Claims Resolution Expert

19 hours ago


Jodhpur, Rajasthan, India beBeeResolution Full time ₹ 9,00,000 - ₹ 12,00,000
Claims Resolution Expert

The Claims Resolution Expert plays a pivotal role in managing the entire claims settlement process from submission to final resolution.

About the Role:
  • Claims Handling: Effectively handle claims from initial assessment to final settlement, ensuring timely and fair resolutions.
  • Data Analysis: Conduct thorough data analysis according to established SOPs (Standard Operating Procedures) to guarantee accurate and efficient claim handling.
  • Claim Validation & Investigation: Conduct investigations by collecting relevant data, conducting interviews, and collaborating with adjusters and external experts to verify claim validity.
  • Client Communication: Maintain open communication with policyholders and agents on claim status, provide clarity on coverage decisions, and guide them through the settlement process.
  • Settlement Negotiation: Negotiate settlement amounts with claimants and third parties, ensuring that settlements are fair, within policy limits, and compliant with legal standards.
  • Documentation & Reporting: Maintain detailed records of claims processing activities, including assessments, investigation reports, and settlement documentation.
  • Fraud Detection: Identify and flag potential fraudulent claims, collaborating with the fraud investigation team when necessary.
  • Compliance: Ensure all claims are processed in adherence to company policies, industry regulations, and legal requirements.
  • Collaboration: Work closely with the legal team on disputed claims or cases involving litigation to ensure proper handling.
  • Customer Service: Deliver exceptional customer service by addressing claim-related inquiries, resolving disputes, and ensuring a smooth claims experience for policyholders.
  • Continuous Improvement: Recommend improvements to enhance efficiency and reduce claims processing time.


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