
Risk Management Specialist
4 days ago
We are seeking a skilled professional to manage the entire claims settlement process, ensuring timely and fair settlements. This is an exceptional opportunity for those with strong analytical skills and experience in insurance claims processing.
Main Responsibilities:
- Claims Assessment: Review submitted documentation and assess claim validity according to policy coverage.
- Data Analysis: Analyze data as per Standard Operating Procedures (SOPs) to ensure accurate and efficient claim handling.
- Claim Investigation: Conduct thorough investigations by collecting relevant data, conducting interviews, and collaborating with experts to verify claim authenticity.
- Client Communication: Keep policyholders informed on the status of claims and guide them through the settlement process.
- Negotiation: Negotiate settlement amounts with claimants and third parties, ensuring that settlements are fair and within policy limits.
- Documentation: Maintain detailed records of claims processing activities.
- Fraud Detection: Identify potential fraudulent claims and collaborate with the fraud investigation team when necessary.
- Compliance: Ensure all claims are processed in adherence to regulatory requirements and company policies.
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