Hiring For Property&Causality Claims/ Claims handler/ Claims associate - Remote - confidential

    confidential
    confidential Remote

    1 week ago

    Full time Healthcare
    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 analysing applicable coverage for claims and determining whether the loss falls within the coverage.
    • Exercise judgement to determine liability by gathering and analysing 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.

    Key skills required:

    • Bachelor's 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.
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