Insurance Claim Resolution Expert

1 day ago

Kurnool, Andhra Pradesh, India beBeeClaims Full time ₹ 12,00,000 - ₹ 18,00,000
Claims Settlement Professional

We are seeking a seasoned Claims Settlement Specialist to oversee the entire claims settlement process from inception to 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 established 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 company policies, industry regulations, and legal requirements.
  • Coordination with Legal Team: Collaborate 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.
Requirements
  • Experience: 3+ years of experience in claims settlement or a related field.
  • Skills: Excellent communication and analytical skills, ability to work independently and as part of a team.
  • Education: Bachelor's degree in a related field.

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