Claims Admin

Role Purpose:

The primary role of this position is to support Claims Adjusters located in North America by completing various complex tasks as instructed. The Claims FNOL Handler will be responsible for a range of activities, including receiving and registering sensitive, high valued and important claims, reviewing insurance policies, documenting claims, and coordinating with adjusters, keeping detailed record of claim-related interactions for compliance and future reference and ensuring that all work is completed accurately and efficiently.

This role is also responsible for providing exceptional support to customers through inbound calls mostly escalated and priority calls. The Claims Admin FNOL role will handle calls that involved complex issues that require higher level support or immediate attention. These can vary from customers with inquiries related to filing claims, submitting new claims, understanding claim requirements, and checking the status of their claims.

Key Responsibilities:

1. Receive and Register Claims: Handle incoming claims from policyholders via phone, email, or online portals, ensuring all necessary information is collected.

2. Gather Information: Ask relevant questions to obtain detailed information about the loss, including circumstances, involved parties, and any immediate actions taken.

3. Document Claims: Accurately record all details of the claim in the claims management system, ensuring compliance with company policies and procedures.

4. Assess Coverage: Review insurance policies to determine coverage eligibility and inform claimants about their coverage status.

5. Provide Guidance: Educate claimants on the claims process, including required documentation and next steps.

6. Coordinate with Adjusters: Collaborate with claims adjusters and other team members to facilitate the investigation and resolution of claims.

7. Maintain Records: Keep detailed and organized records of all claims interactions and documentation for future reference and audits.

8. Customer Service: Deliver exceptional customer service by addressing claimant inquiries, resolving issues, and providing timely updates on claim status.

9. Ensure the quality of work is achieved by adhering to established standards and procedures, conducting self-reviews, and seeking feedback when necessary.

10. Collaborate with team members and other departments and raise any issues or challenges encountered to ensure a smooth workflow throughout the claims process.

11. Stay informed about company policies, procedures, and industry regulations to ensure compliance in all tasks performed.

12. Participate in training and development opportunities to enhance skills and knowledge related to claims handling and customer service.

13. Pass all certification exams in various trainings attended.

Experience:

• Excellent attention to detail, with the ability to manage multiple tasks effectively.
• Excellent communication skills, both written and verbal, with a focus on providing exceptional customer service.
• Ability to organize work effectively and methodically and as a team and adjust to change driven by business needs.
• Ability to maintain a high level of quality in all claims administration activities ensuring the settlement times and complaint levels are minimized.
• Ability to handle sensitive information with confidentiality and professionalism.
• Sound knowledge of claims administration procedures and related systems.
• Possess strong customer service behaviour.
• Proficient in Microsoft Office Suite (Excel, Word, PowerPoint) and claims management software.
• Ability to work independently and collaboratively in a fast-paced environment.

Qualifications:

• Tertiary Qualified or minimum of 2 years of experience in claims handling, administrative support, with voice process or a related role, preferably within the insurance industry.
• Familiarity with call center software and customer relationship management (CRM) systems
• Claims processing, insurance industry or customer service background for at least 6 months is required.
• Able to work on a night shift schedule.

Languages:

English = 5/5 and Filipino = 4/5

• Strong verbal and written communication skills in English including clarity, tone and articulation are essential for interacting with claimants and documenting claims accurately.