Claim Analyst

Responsibilities:

• Review and Investigate Claims: Examine insurance applications and documents for completeness and accuracy.

• Evaluate Claims: Investigate, evaluate, and process insurance claims to determine their validity and legality.

• Determine Coverage and Liability: Apply insurance policies and regulations to claims and determine the correct payout amount.

• Communicate with Stakeholders: Communicate with claimants, witnesses, and insurance carriers to gather pertinent information.

• Negotiate Settlements: Negotiate claim settlements and manage the disbursement of funds to policyholders.

• Documentation: Document all findings and actions taken for each claim.

• Fraud Investigation: Conduct investigations when a claim appears to be fraudulent or has other complex circumstances.

• Reporting: Prepare reports on claim outcomes and trends.

• Compliance: Stay updated on new laws, regulations, and procedures regarding insurance claims.

Role Requirements:

• Education: Bachelor's degree in Business, Finance, Insurance, or a related field.

• Experience: Proven work experience as a Claims Analyst, Claims Specialist, or similar role

• Strong analytical and problem-solving skills.

• Excellent communication and negotiation skills.

• Proficiency in using claims management software and Microsoft Office Suite.

• Ability to work independently and manage multiple tasks.

• Knowledge of insurance policies, regulations, and procedures.

• Certifications: Relevant certifications in insurance or claims management are a plus.