Operations Support - Commercial Insurance Claims

Who are we

• Must have experience in insurance Domain, Property & Casualty, medical health Claims processing and Operations. 
• Create, update, and maintain operations / SOP documents and access systems on behalf of the Claims leadership group and provide the right data to them.
• Need ability to operate effectively at all levels, from managing front line employees to interacting with      executives.
• Demonstrate ability to identify and implement efficiencies within an operations environment.
• Need ability to manage operational inventory to meet stated Service Level Agreements.
• Ensure that all activity is properly documented within the appropriate Client system.
• Communicate with Global Claims relationship managers to support their delivery and execution of the global claims strategy to assigned carriers and promote continued engagement.
• Manage and process claims related to property damage, personal injury, and liability.
• Investigate the validity of claims, assess coverage, and ensure accurate settlement outcomes.
• Collaborate with adjusters, legal teams, and clients to resolve claims efficiently.
• Review policy details with clients to ensure clear understanding and compliance.
• Maintain accurate records of policies, claims, communications, and necessary documentation.
  

Requirements

• Good verbal and written communication skills.
• Knowledge on how to use claims processing tools like File Handler
• Must be able to communicate with onsite people. 
• Working knowledge of Medical health claims processing.
• Experience in working for medical stop loss and healthcare industry for US Clients
• Need ability to operate effectively at all levels, from managing front line employees to interacting with executives
• Demonstrate ability to identify and implement efficiencies within an operations environment
• Need ability to manage operational inventory to meet stated Service Level Agreements
• Ensure that all activity is properly documented within the appropriate Client system
• Communicate with Global Claims relationship managers to support their delivery and execution of the global claims strategy to assigned carriers and promote continued engagement