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Insurance Claims Officer

HYLA Mobile

HYLA Mobile

India · Remote
Posted on Friday, May 31, 2024

Insurance Claims Officer, GCC, India

The Insurance Claims Officer exists to load, process and adjudicate a portfolio of Finance Claims, whilst keeping customers updated throughout the claim process.

This position will be Remote at our India location.

What will be my duties and responsibilities in this job?

  • Register, assess and process all insurance claims assigned to this position and decide/recommend on claims acceptance or make recommendations for denials in accordance with the relevant Claims Procedures and in accordance with this position’s prescribed Delegated Financial Authority Limit to ensure that claim acceptance is based on the policy conditions being meet, denials are legally correct and all decisions adhere to the compliance standards set by the underwriters and governed by regulatory authorities
  • Authorise claim payments in accordance with this position’s prescribed Delegated Financial Authority Limits and liaise with the Senior Claims & Customer Service Manager in regard to any uncertainty with any claim and precautionary measures to prevent fraud and double, excessive or under payment of insurance claim settlements.
  • Immediately notify the Senior Claims & Customer Service Manager when a valid Large Loss estimate of $30,000 or more is raised.
  • Answer general enquiries about our insurance product lines and the insurance claims management process including how to lodge insurance claims and the information customers need to provide to support their insurance claim and provide customers with updates on the progress updates and expected settlement dates for insurance claims and direct all other enquires this position is unable to answer to the appropriate person within the business.
  • Resolve complaints efficiently in accordance with the Internal Disputes Resolution & Denial procedure.
  • Liaise with Senior Claims & Customer Service Manager in regard to any uncertainty with any insurance claim and with any fraudulent activity identified to ensure that preventative measures including system controls and audits are in place to mitigate the risk of fraud or errors with financial insurance claims.
  • Assist in the completion of the End of Month process by reviewing all open claims assigned to this position to ensure that reserves for claims have been adequately set and settled or not taken up claims are archived by the last working day of End of Month
  • Support the Senior Claims & Customer Service Manager in meeting the operational objectives of the claims department through the development of new staff in the insurance claims management process for the insurance claims assigned to this position including legal liability, the refinement of existing insurance claims processes and system controls.
  • Complete development and project work as assigned from time to time by the Senior Claims & Customer Service Manager.

NB: Insurance Products & Insurance Claims Includes:

  • Payment Protection Insurance
  • Lifestyle Protection Insurance
  • Guaranteed Asset Protection (GAP) Insurance
  • Contingent Debt Insurance

What are the requirements needed for this position?

  • Minimum 2 years medical / disablement including effective management of complex claims settlements, denials, disputes and complaints.
  • Effective written and verbal communication, comprehension and investigative skills
  • Basic to Intermediate skill level for Microsoft Outlook, Excel and Word
  • Passionate about delivering exceptional customer service.
  • Inherently empathic and advocates for the consumer
  • Detailed analyst with the ability to make discretionary decisions with only partial information
  • Resilient when faced with conflict and recognizes and seeks out support when needed.
  • Self-disciplined and motivated towards achieving goals.
  • Prior working experience with either of the Insurance Products & Insurance Claims:- Payment Protection Insurance OR Lifestyle Protection Insurance OR Guaranteed Asset Protection (GAP) Insurance OR Contingent Debt Insurance.