
Insurance Claims Resolution Specialist
2 days ago
Job Title: Insurance Claims Resolution Specialist
We are seeking a highly skilled professional to lead the claims resolution process. As an expert in insurance policies and claims procedures, you will be responsible for assessing claims, investigating their validity, and ensuring timely and fair settlements.
Key Responsibilities:
- Claims Evaluation: Conduct thorough assessments of submitted claims, analyzing policy coverage and determining eligibility.
- Data Analysis: Utilize data analysis skills to ensure accurate and efficient claim handling, adhering to Standard Operating Procedures (SOPs).
- Claim Validation & Investigation: Collect relevant data, conduct interviews, and collaborate with adjusters and external experts to verify claim validity.
- Client Communication: Maintain clear and transparent communication with policyholders, keeping them informed on the status of claims and providing clarity on coverage decisions.
- Negotiation & Settlement: Negotiate settlement amounts with claimants and third parties, ensuring that settlements are fair and within policy limits.
- Documentation & Reporting: Maintain detailed records of claims processing activities, including assessments and investigation reports.
Required Skills & 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.
Benefits:
- Competitive salary and benefits package.
- Ongoing training and development opportunities.
- Collaborative and dynamic work environment.
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