Job Description

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.