Insurance Claims Associate 16F25

The Insurance Claims Associate is a crucial position within the insurance sector, dedicated to managing and processing claims efficiently and accurately. This role requires an organized and detail-oriented individual who can evaluate and negotiate claims settlements while ensuring adherence to company policies and industry regulations. An ideal candidate for this position will have strong analytical skills, effective communication abilities, and a keen eye for detail. As an Insurance Claims Associate, you'll be responsible for determining the validity of claims, coordinating with clients, adjusters, and medical professionals, and managing a portfolio of claims using industry-standard software and practices. This position offers an exciting opportunity to join a dynamic team and contribute to the financial protection and satisfaction of our clients.

Responsibilities

• Review, evaluate, and process insurance claims in a timely manner.
• Determine insurance coverage and the extent of the company’s liability.
• Communicate effectively with policyholders, adjusters, and other relevant parties.
• Gather and analyze documentation and reports to support claim validation.
• Negotiate settlements with claimants and medical providers to reach a fair conclusion.
• Maintain accurate and detailed records of insurance claims using company systems.
• Ensure compliance with legal and regulatory requirements throughout the claims process.
• Provide exceptional customer service by addressing claim inquiries and concerns.
• Identify and investigate any potentially fraudulent claims to prevent losses.
• Collaborate with internal and external stakeholders for efficient claim resolutions.
• Prepare and present detailed reports on claim activity and trends as required.
• Continuously update knowledge of industry regulations, best practices, and new technologies.

Requirements

• Bachelor's degree in business, finance, or a related field preferred.
• Previous experience in insurance claims or a related field is advantageous.
• Strong analytical and problem-solving skills essential for evaluating claims.
• Excellent written and verbal communication skills for effective client interactions.
• Proficient in using claims management software and other relevant applications.
• Ability to handle multiple claims simultaneously with strong organizational skills.
• Thorough understanding of insurance policies, regulations, and industry standards.
• Ability to negotiate confidently and fairly with various stakeholders.
• High level of integrity and professionalism in handling sensitive information.