Job description
- Document claim file by accurately capturing and updating claims data/information in compliance with best practices for low to moderate. exposure and complexity for Property and Content damage and Liability/Injury claims.
- Exercise judgement to determine policy verification and coverage determination by analyzing applicable coverage for claims and determining whether the loss falls within the coverage.
- Exercise judgement to determine liability by gathering and analyzing relevant facts, images; utilizing applicable coverages.
- Identify anomalies and patterns to identify fraudulent claims and refer to SIU team based on SOPs.
- Work to have a timely resolution to claims with complete ownership from initiation/intake to settlement.
- Assess damages by calculating applicable damage or range of damages.
- Negotiate settlement of a claim by establishing the appropriate negotiation strategy and utilizing available resources within authority limits.
- Meet quality standards by following best practices.
- Responsible for data integrity and the appropriate documentation of the claim file as well as for compliance with regulatory requirements.
- Accountability in customer satisfaction and execute on the strategy to provide the best claims service for host damage protection.
- Ensure customer service by proactively communicating information, responding to inquiries, following customer protocols and special handling instructions.
- Ensure legal compliance by following federal laws and regulations, and internal control requirements.
Job qualification and other skills/competencies
- Bachelors degree or college Diploma.
- Experience in P&C, Healthcare Claims dealing with damage, liability or injury claims.
- Good knowledge of Insurance claims end-to-end value chain activities, challenges and best practices.
- Good knowledge of how to evaluate injuries and damage using market tools and technology.
- General knowledge of the coverages available under the damage protection, liability policy and some common exclusions.
- Results driven, ability to multi-task, pay attention to detail and follow procedures.
- Proven leadership and time management skills in a team environment.
- Good writing, communication and presentation skills.Role & responsibilities
JOB IS EXPIRED.