Claims Settlement Specialist
4 days ago
**About HR Genie**
We are a leading company in the insurance industry, and we are seeking a skilled Claims Settlement Specialist to join our team.
**Salary:** $65,000 - $85,000 per annum
**Job Description:**
Key Responsibilities:- Claims Handling:
- Maintain high standards of claims settlement and provide excellent customer service.
- Register and manage claims for personal and commercial policies.
- Appoint assessors and ensure sufficient cover.
- Settle claims efficiently and accurately update data systems.
- Manage claims from start to settlement stage.
- Gather information from clients and involved parties.
- Examine claim details and check against policy cover.
- Consult with staff to decide claim outcomes and compensation.
- Inform clients of claim outcomes in writing.
- Refer complex claims to professionals like loss adjusters.
- Determine claim merits based on facts and investigations.
- Settle claims within parameters to avoid leakage.
- Obtain necessary information for settlement or rejection.
- Adjust reserves continuously.
- Arrange car hire for insured clients in accidents.
- Deal with contractors for critical documents.
- Manage salvage processes.
- Negotiate claims with clients, service providers, and insurers.
- Keep detailed file notes of discussions.
- Negotiate contentious claims with insurers and clients.
- Refer potential errors to Claims Manager.
- Complete claim files upon finalisation and file to EDS.
- Maintain claims files according to operational standards.
- Update systems daily.
- Promptly handle complaints and queries.
- Ensure speedy resolution of queries and complaints.
- Submit insurer feedback and reports as agreed.
- Provide a pleasant claims experience.
- Foster sound relationships with clients, colleagues, markets, and service providers.
- Maintain policy updates after claims.
- Update underwriting items for deletion or replacement.
- Record reports submitted to clients.
- Service Delivery:
- Ensure customer satisfaction through service delivery.
- Maintain service quality and desired outputs within specific processes.
- Resolve escalated customer queries and complaints.
- Develop work routines to achieve service delivery goals.
- Share knowledge on new standards and procedures.
- Continuous Improvement:
- Adhere to organisational policies and procedures.
- Identify areas for process improvement.
- Recommend improvements.
- Confirm DOFA compliance.
- Experience with Cardinal 360 system is an advantage.
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