Claims Resolution Specialist

1 week ago

Hubli, Karnataka, India beBeeClaims Full time ₹ 17,24,000 - ₹ 20,12,000
Insurance Claims Resolution Professional

The role of an Insurance Claims Resolution Professional is to handle the entire claims process, from submission to final resolution, ensuring that settlements are fair, within policy limits, and compliant with legal standards.

  • Key Responsibilities:
  • Manage the claims process, including reviewing submitted documentation and determining eligibility based on policy coverage.
  • Analyse data according to Standard Operating Procedures (SOPs) to ensure accurate and efficient claim handling.
  • Conduct thorough investigations by collecting relevant data, conducting interviews, and working with adjusters and external experts to verify claim validity.
  • Negotiate settlement amounts with claimants and third parties.
  • Maintain detailed records of claims processing activities, including assessments, investigation reports, and settlement documentation.
  • Identify and flag potential fraudulent claims, collaborating with the fraud investigation team when necessary.
  • Ensure all claims are processed in adherence to industry regulations and legal requirements.
  • Collaborate with the legal team on disputed claims or cases involving litigation.
  • Deliver exceptional customer service by addressing claim-related inquiries, resolving disputes, and ensuring a smooth claims experience for policyholders.
Requirements:
  • Bachelor's degree in Insurance, Risk Management, Business Administration, or a related field.
  • Strong understanding of insurance policies, claims processes, and regulatory requirements.
  • Proven negotiation and conflict resolution skills.
  • Ability to analyse complex claims data for fair settlement decisions.
  • Strong communication skills, both verbal and written.
  • Attention to detail with excellent organisational abilities.

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