Insurance Claims Associate 10D25

As an Insurance Claims Associate, you will play a crucial role in the claims management process within our insurance organization. This position requires a detail-oriented individual with excellent communication skills who is capable of effectively evaluating claims, determining liability, and verifying the authenticity of submitted claims. You will serve as a critical liaison between policyholders and insurance companies, ensuring that claims are processed in an accurate and timely manner. This is an exciting opportunity to contribute to a vital facet of the insurance industry, where your keen eye for detail and customer service skills will directly impact policyholder satisfaction and trust in our services. Ideal candidates will possess strong analytical abilities and a desire to make a tangible difference in claims-related results.

Responsibilities

• Review insurance claims documents thoroughly to verify accuracy and completeness.
• Conduct investigations by gathering necessary information to validate claims.
• Liaise with policyholders to clarify details and gather additional required documentation.
• Evaluate claims to determine the company's liability in accordance with policy terms.
• Coordinate with third parties for additional information, including medical or repair reports.
• Ensure compliance with industry regulations and company policies in all claim processes.
• Prepare detailed reports and summaries for claim determinations and recommendations.
• Manage claim files and maintain comprehensive records within the claims management system.
• Communicate claim decisions and explanations clearly to policyholders and stakeholders.
• Identify claims that require special handling and escalate them to appropriate departments.
• Conduct follow-ups on claim resolutions and ensure timely settlements are reached.
• Continuously update knowledge of company policies and industry developments affecting claims.

Requirements

• Bachelor's degree in insurance, business, finance, or a related field preferred.
• Prior experience in insurance claims processing or a related field is beneficial.
• Strong analytical skills and attention to detail are critical for success in this role.
• Excellent communication skills to interact with policyholders and other stakeholders.
• Ability to work independently and manage multiple claims simultaneously.
• Familiarity with claims management software and proficiency in office software applications.
• Understanding of industry-related regulations and compliance requirements is advantageous.