Claim Processing Executive 26O25

As a Claim Processing Executive, you will play a crucial role within the insurance industry by overseeing the assessment and validation of claims submitted by policyholders. You will act as a liaison between clients and the insurance company, ensuring that all claims are processed efficiently, accurately, and in a timely manner. This position demands a keen eye for detail, strong analytical skills, and the ability to handle a high volume of claims with varying degrees of complexity. A successful Claim Processing Executive possesses excellent communication skills and maintains a high level of customer service. You will need to be adaptable to changing regulations and industry standards to ensure compliance while providing an exceptional experience for all stakeholders involved in the claims process.

Responsibilities

• Review and process insurance claims with accuracy and thoroughness.
• Communicate with clients to gather necessary documentation for claim processing.
• Evaluate claim validity through careful analysis of submitted information.
• Ensure compliance with legal and company standards throughout all claim assessments.
• Maintain detailed records of claim activities and prepare detailed reports.
• Collaborate with other team members to improve processing efficiency and outcomes.
• Escalate complex claims to senior management for further investigation as necessary.
• Provide high-quality customer support to resolve inquiries and issues promptly.
• Stay informed on industry trends and changes in regulations affecting claims processing.
• Identify and report any suspicious or potentially fraudulent claims for further review.
• Liaise with underwriters and risk analysts for claim validations and assessments.
• Constantly seek to improve knowledge on new products and claim processing technologies.

Requirements

• Bachelor’s degree in Business Administration, Finance, or related field preferred.
• Minimum of two years of experience in insurance claim processing required.
• Demonstrated ability to handle multiple tasks and manage time effectively.
• Excellent analytical and problem-solving skills with attention to detail.
• Strong communication skills, both verbal and written, to interact with clients.
• Proficiency in basic office software and claim processing applications essential.
• Ability to work under pressure and meet strict deadlines consistently.