Job Description
Claims Processing and Management:
Oversee the end-to-end claims process, from initial claim notification to settlement and closure.
Ensure that all claims are processed in a timely and accurate manner, adhering to company policies and regulatory requirements.
Review and assess complex and high-value claims, providing guidance and support to claims adjusters.
Team Leadership:
Lead, mentor, and develop the claims team, ensuring they have the skills and knowledge required to perform their roles effectively.
Conduct regular performance reviews and provide feedback to team members to drive continuous improvement.
Customer Service:
Ensure a high level of customer satisfaction by addressing customer inquiries, complaints, and disputes promptly and professionally.
Develop and implement customer service strategies to enhance the overall claims experience for policyholders.
Claims Analysis and Reporting:
Monitor and analyze claims data to identify trends, risks, and opportunities for improvement.
Prepare regular reports on claims performance, including loss ratios, claims processing times, and customer satisfaction metrics, for senior management.
Compliance and Risk Management:
Ensure that all claims activities comply with legal and regulatory requirements, as well as internal company policies.
Work closely with the risk management team to identify and mitigate potential risks associated with claims.
Process Improvement:
Identify and implement process improvements to enhance the efficiency and effectiveness of the claims department.
Utilize technology and data analytics to streamline claims processes and reduce processing times.
Vendor Management:
Manage relationships with external service providers, such as loss adjusters, legal firms, and repair contractors, to ensure quality service delivery.
Requirements
Bachelor’s degree in Business Administration, Insurance or a related field.
Proven experience in a similar role, from the insurance industry.
Professional certification in insurance (e.g., ACII, AIIK) is preferred.
Advanced training in claims management or risk management is an advantage.
Proficiency in Microsoft Office Suite and other relevant software applications.
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