Handles non-routine complex issues pertaining to claims complications and claims processes, escalating where necessary, to ensure application of pertinent policy and action calculation of claims rates.
Reviews claims reports of high complexity to ensure accurate records are produced and distributed.
Distributes new claims notifications and updates to the team in order to ensure information shared is consistent and clear.
Ensures incoming documentation from clients and underwriters, guidance and feedback to colleagues are filed to keep documentation organized.
Inspects receipt of documentation by mail or phone to ensure operational excellence and to maintain ongoing and professional communication with insurers, clients, and underwriters to ensure that client and insurer-related materials are catalogued, distributed, and readily available to the team.
Reviews high volume of claims information on appropriate claims application(s) and ensures compliance with any local service standards to maintain accurate records for Claims Advisory.
Creates standard templates for insurance claims forms and reviews templates for effectiveness to ensure consistent deliverables are produced by support staff.
Checks claim files and ensures files with missing information are properly flagged and follow up correspondence is sent to insured or other involved persons for missing or supplemental information.
Identifies potential policies and coverages for incoming claims, performing independent research to seek validation or clarification where necessary to add leverage to Claims Advisory and support claims analysts.