Claims Officer

Description

We are seeking a meticulous and dedicated Claims Officer to join our insurance team. The successful candidate will play a pivotal role in the claims processing department, ensuring that all claims are handled with accuracy and efficiency. As a Claims Officer, you will be responsible for evaluating insurance claims, gathering necessary documentation, and determining the validity of claims according to company policies and industry regulations. You will act as a liaison between clients and the insurance company, addressing inquiries and providing clear communication throughout the claims process.

Key Objectives

• Accurately assess and process insurance claims in line with company policies and regulatory requirements.
• Facilitate timely communication with claimants, adjusters, and other stakeholders to ensure smooth claim resolution.
• Identify potential risks or fraudulent activities and escalate appropriately.
• Maintain detailed records and documentation to support claim decisions and audits.

Responsibilities

• Review and evaluate incoming insurance claims for completeness and validity.
• Investigate claims by gathering necessary information, including policy details and claimant statements.
• Coordinate with internal departments and external parties such as medical professionals, legal advisors, and repair services.
• Determine claim eligibility and calculate appropriate settlements based on policy terms.
• Communicate claim decisions clearly and professionally to customers.
• Monitor claim progress and ensure timely resolution to enhance customer satisfaction.
• Maintain compliance with industry regulations and company standards throughout the claims process.
• Prepare reports and documentation for management review and audit purposes.

Requirements

• Bachelor’s degree in Business, Insurance, Finance, or a related field.
• Proven experience in claims processing or insurance underwriting preferred.
• Strong understanding of insurance policies, claims procedures, and regulatory frameworks.
• Excellent analytical and problem-solving skills.
• Effective communication skills, both written and verbal.
• Attention to detail with the ability to manage multiple claims simultaneously.
• Proficiency in claims management software and MS Office applications.
• Ability to work independently and collaboratively within a team environment.

Benefits

• Competitive salary and performance-based incentives.
• Comprehensive health and wellness benefits.
• Opportunities for professional development and career growth.
• Supportive and inclusive workplace culture.
• Work-life balance initiatives and flexible working arrangements.