Insurance Claims Processor

11 hours ago

Davangere, Karnataka, India beBeeClaims Full time ₹ 8,00,000 - ₹ 12,00,000

Claims Resolution Specialist

This role involves managing the entire claims process from submission to final resolution.

Key Responsibilities:

  • Claims Processing: Handle the entire claims process, from reviewing submitted documentation to determining eligibility based on policy coverage.
  • Data Analysis: Analyze data according to provided SOPs (Standard Operating Procedures) to ensure accurate and efficient claim handling.
  • Claim Validation & Investigation: Conduct thorough investigations by collecting relevant data, conducting interviews and working with adjusters and external experts to verify claim validity.
  • Client Communication: Keep policyholders and agents informed on the status of claims, 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 industry regulations and legal requirements.

Key Qualifications:

  • Strong understanding of insurance policies and claims processes.
  • Proven negotiation and conflict resolution skills.
  • Ability to analyze complex claims data for fair settlement decisions.
  • Strong communication skills, both verbal and written.
  • Attention to detail with excellent organizational abilities.

About This Role: We're a dynamic organization committed to delivering high-quality results and exceptional customer service. Our team is passionate about helping customers navigate the claims process efficiently.

What We Offer: A challenging role with opportunities for professional growth and development, a collaborative work environment, and a competitive compensation package.

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