Claims Specialist

J ob description of Claims Specialist:- A Claims Specialist plays a crucial role in the insurance industry by evaluating and processing insurance claims to ensure accuracy, compliance, and timely resolution. Here's an overview of the role, including key responsibilities, qualifications, and skills. Key Responsibilities Claims Evaluation: Assess and process insurance claims by reviewing documentation, verifying policy details, and determining coverage eligibility. Investigation and Fraud Detection: Investigate claims thoroughly to identify potential fraud or discrepancies, ensuring the integrity of the claims process. Settlement Negotiation: Negotiate settlements with claimants, ensuring fair and timely resolutions in accordance with policy terms. Communication: Maintain clear communication with policyholders, claimants, attorneys, and other relevant parties to provide updates and gather necessary information. Documentation and Reporting: Maintain accurate records of all claims activities, ensuring compliance with company policies and regulatory requirements. Customer Service: Provide exceptional customer service by addressing inquiries, resolving issues, and guiding clients through the claims process. Skills: investigation,insurance,compliance,attorneys,communication,fraud,insurance claims,reporting,fraud detection,documentation,customer,settlement negotiation,claims evaluation,customer service Show more Show less