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Team Lead- Claims

0 years

0 Lacs

Posted:2 days ago| Platform: Linkedin logo

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On-site

Job Type

Full Time

Job Description

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Description

Davies is seeking a highly organised and self-motivated professional to join our Life & Health team as an Administrator Team Leader. In this role, you will provide leadership, guidance, and direction to a dedicated team, ensuring the achievement of key results and operational excellence. Your responsibilities will include overseeing document indexing, imaging, quality audits, data entry and the review of Proof of Loss (POL), as well as processing policy documents and claims. You will play a critical role in handling sensitive files and processing essential documents to support our US operations.This is an excellent opportunity for a proactive and detail-oriented individual looking to make an impact within a dynamic and collaborative environment.

Key Responsibilities

We will start to build your skill set with the vision that you increase in competence across all activities in your role day to day but also broaden capacity across all administration areas.

People & Process Management:

  • Provide daily direction and communication to employees so that processes run in an efficient manner
  • Assist in developing clear and measurable performance criteria for all assigned team members and remain accountable to team output and contributions
  • Manage all established productivity and quality standards to meet or exceed goals by monitoring all productivity to ensure timely output
  • Act as primary resource for questions and support needs
  • Monitor and manage work queues and offer assistance when needed
  • Manage workflow requests and ensure they are processed efficiently throughout the working day
  • Provide coaching, feedback, performance management including and up to management of a performance improvement plan (PIP) and termination

Inbound Document Indexing & Verification:

  • Accurately and efficiently index inbound documents into document retention system
  • Use data entry to process information from documents to ensure accuracy
  • Classify, and index documents to correlating policyholder policies/claims
  • Understand and recognize relevant identifiers such as policy number, claim number, etc. to accurately and efficiently support all operational departments with incoming documents
  • Review and understand different document types, which included various legal documents
  • Respond promptly to internal and external customer needs and request for service assistance

Document and Phone Quality Audit:

  • Review calls to verify correct information was provided and call was properly documented
  • Perform quality audits efficiently and effectively
  • Reviewed completed inquiries to verify correct action was taken included follow up completed as necessary
  • Draft feedback in a coaching and positive manner

Policy Document Processing

  • Processing policy documents
  • Perform data entry of various types of documents
  • Identify and escalate issues in a timely manner

Claims Management and Claims Payment

  • Proof of Loss Document Evaluation and set-up for identified recertifications
  • Correct/Update provider information
  • Handle Failed Faxes
  • Process Payments
  • Quarterly and Year end evaluation of 1099s

Miscellaneous Duties:

  • Excellent oral communications skills must speak clearly and persuasively in positive or negative situations. Listens and gets clarification, responds well to questions, demonstrate group presentation skills, participates in meeting.
  • Perform other duties and projects as assigned

Skills, Knowledge & Expertise

  • Collaboration

  • Decision Making Skills

  • Initiative

  • Oral Communication

  • Planning/Organizing

  • Quality

  • Written Communication

  • Knowledge of insurance and the insurance market

  • Excellent computer literacy with fast and accurate keyboard skills

  • Data inputting experience and good data integrity

  • The ability to work as part of a team
  • To take responsibility for your workload
  • Must be able to demonstrate adaptability and flexibility
  • Good planning and organisational skills
  • Previous experience working in an administration role is preferable but not essential
  • Is proactive and resilient, seeking to get things done and, at the same time, deal with a variety of tasks
  • Work to deadlines to achieve client service level agreements in a changing and demanding environment
  • Able to demonstrate effective management of time and resources
  • Can demonstrate evidence of being an effective team member, interacting positively with colleagues, and communicating effectively with diverse people
  • Actively seeking and responding to feedback

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