JOB SUMMARY:

The Insurance Claims Administrator is responsible for managing, processing, and assessing insurance claims accurately and efficiently. This role involves direct interaction with clients and insurance companies to ensure timely and fair resolution of claims in accordance with company policies and regulatory requirements.

QUALIFICATIONS & SKILLS:

• High school diploma or equivalent.
• Strong attention to detail and organizational skills.
• Excellent written and verbal communication.
• Proficiency in Microsoft Office suite.
• Ability to multitask and meet deadlines in a fast-paced environment.
• Knowledge of insurance products, terminology, and claims processes.

• Claims Processing:
• Receive, review, and process incoming insurance claims.
• Verify accuracy, completeness, and compliance of submitted documentation.
• Input claim data into internal systems and maintain up-to-date records.
• Communication & Coordination:
• Liaise with clients, insurance companies, brokers, and other parties to gather necessary information.
• Provide updates to clients on the status of their claims.
• Respond to inquiries and resolve issues in a professional and timely manner.
• Assessment & Resolution:
• Assist in determining claim validity and policy coverage.
• Flag potentially fraudulent claims for further investigation.
• Follow up on outstanding documents and manage timelines to ensure efficient claim closure.
• Compliance & Documentation:
• Ensure claims are handled in accordance with company policies, insurance laws, and data protection regulations.
• Maintain accurate and detailed records of all claim-related activities.
• Generate reports and summaries for internal tracking and auditing purposes.
• Support & Improvement:
• Support the Claims Manager with reporting, process improvements, and audits.
• Contribute to the development of claims procedures and best practices.