Claims Specialist

Job Purpose:

The primary responsibility of this role is to manage and service Group Personal Accident (GPA) claims, ensuring efficient processing, proper documentation, and timely resolution. The role requires maintaining an updated claims database, coordinating with claimants, handling queries, and ensuring adherence to claim settlement timelines.

Primary Job Responsibilities:

Scrutinization & Claim Status Updation:

• Review claim documents for completeness and accuracy.
• Update claim status on the ARIBL Claim Portal based on received documents.
• Flag discrepancies or missing information for timely resolution.

MIS Maintenance & Analytics:

• Maintain a comprehensive MIS for all claims, ensuring data accuracy.
• Generate analytical reports to track claim trends and performance metrics.

TAT Management for Claim Clearance:

• Ensure that all claims are processed within the defined Turnaround Time (TAT).
• Coordinate with internal teams and external stakeholders to expedite settlements.

Handling Queries & Claimant Assistance:

• Address email queries from claimants, Client, and other stakeholders.
• Attend to personal visits from claimants at desk, providing necessary guidance and support.

Presentation & Awareness Program Preparation:

• Prepare PowerPoint presentations (PPTs) for seminars, awareness programs, and training sessions.
• Conduct workshops or training to educate stakeholders about the GPA claim process.

PAN-India Claimant Visits (As Required):

• Travel across India to meet claimants, assisting with awareness of the policy, and resolution of issues.
• Liaise with regional and corporate SBI offices to facilitate smooth claim processing.

Key Skills & Competencies:

Strong knowledge of insurance claim processing and documentation.

Proficiency in MIS management, reporting, and analytics.

Ability to handle customer queries with professionalism and empathy.

Strong coordination and follow-up skills to ensure timely claim resolution.

Presentation and training skills to conduct awareness programs.

Willingness to travel PAN India as per business requirements.