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 teamenvironment.
