Chief Claims Resolution Officer

7 hours ago

Kota, Rajasthan, India beBeeFraud Full time ₹ 9,00,000 - ₹ 12,00,000

Insurance Claim Specialist Role

We are seeking an experienced professional to manage the entire claims settlement process from submission to final resolution. This role involves handling complex insurance claims, analyzing data, and communicating with policyholders and agents.

Key Responsibilities:
  • Claims Processing: Review submitted documentation, determine eligibility based on policy coverage, and ensure accurate and efficient claim handling.
  • Data Analysis: Analyze data according to provided SOPs to identify trends and areas for improvement in the claims process.
  • Claim Validation & Investigation: Conduct thorough investigations by collecting relevant data, conducting interviews, and collaborating 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.
  • Fraud Detection: Identify and flag potential fraudulent claims, collaborating with the fraud investigation team when necessary.
Requirements:
  • Strong Understanding: Of insurance policies, claims processes, and regulatory requirements.
  • Negotiation Skills: Proven negotiation and conflict resolution skills to resolve disputes and reach fair settlements.
  • Data Analysis: Ability to analyze complex claims data for fair settlement decisions.
  • Communication: Excellent communication skills, both verbal and written, to effectively communicate with policyholders and agents.
  • Attention to Detail: Attention to detail with excellent organizational abilities to manage multiple claims and deadlines.

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