- Receive and review insurance claims, including property damage, liability, and personal injury claims, to determine coverage and eligibility.
- Conduct thorough investigations into the circumstances surrounding each claim, gathering relevant information, documents, and evidence.
- Evaluate claim documentation, policy terms, and legal regulations to determine the validity of claims and assess liability.
- Communicate with claimants, policyholders, witnesses, and other relevant parties to obtain additional information and clarify details of the claim.
- Provide clear and accurate explanations of coverage, claim decisions, and settlement options to claimants and policyholders.
- Process claims payments, settlements, and reserves in accordance with company policies and regulatory requirements.
- Negotiate settlement agreements with claimants or their representatives, seeking to achieve fair and equitable resolutions.
- Collaborate with internal departments, including underwriting, legal, and finance, to address complex claims issues and mitigate risk.
- Maintain detailed and organized claim files, documenting all relevant activities, communications, and decisions throughout the claims process.
- Stay current on industry trends, regulatory changes, and best practices in claims handling to enhance knowledge and performance.
- Bachelor's degree in Business, Finance, Risk Management, or related field preferred.
- Proven experience in insurance claims handling or related field, with a strong understanding of insurance principles, policies, and procedures.
- Excellent analytical skills with the ability to evaluate information, assess risk, and make sound decisions.
- Strong communication and interpersonal skills, with the ability to effectively interact with diverse stakeholders.
- Detail-oriented approach with a focus on accuracy and precision in claim documentation and processing.
- Ability to prioritize tasks, manage workload efficiently, and meet deadlines in a fast-paced environment.
- Proficiency in computer applications and claims management software.
- Knowledge of insurance regulations and compliance requirements.
- Strong negotiation skills with the ability to resolve conflicts and negotiate favorable outcomes.
- Commitment to providing exceptional customer service and building positive relationships with clients and colleagues.
- Professional certification in claims adjusting or risk management (e.g., AIC, ARM) is a plus.
- Experience handling complex or high-value insurance claims.
- Familiarity with various types of insurance coverage, including property, casualty, and liability.
- Bilingual proficiency in languages commonly spoken by our client base may be advantageous.
