Assistant Manager - Claims

Role & responsibilities

1. Claims Management:

• Oversee the entire claims process, from initial claim submission to final settlement.
• Ensure claims are handled efficiently, accurately, and within the designated timelines.
• Review and analyze claims to assess their validity, potential liability, and appropriate compensation.

2. Team Leadership:

• Lead, train, and manage a team of claims adjusters, analysts, and support staff.
• Set performance objectives and provide regular feedback to ensure team members meet company standards.
• Resolve any internal or external issues related to claims handling or staff performance

3. Claims Investigation and Evaluation:

• Review claims and assist in complex or high-value claim investigations.
• Ensure thorough evaluation of claims to determine appropriate course of action and compensation.
• Collaborate with legal teams when necessary to address complex legal or regulatory issues related to claims.

4. Customer Service:

• Provide exceptional customer service by addressing client concerns and providing timely updates on claim status.
• Communicate effectively with claimants, legal representatives, vendors, and other stakeholders to facilitate claims resolution.
• Compliance and Risk Management:
  
• Ensure that all claims are processed in accordance with company policies, industry regulations, and legal requirements.
• Monitor changes in laws, regulations, and industry trends to ensure compliance.
• Implement strategies to minimize the risk of fraudulent claims and unnecessary claims costs.

• Reporting and Analysis:
  
• Prepare and maintain reports on claims trends, claim statuses, and outcomes.
• Analyze claims data to identify areas for improvement in claims processes or cost containment.
• Provide regular updates to senior management on claims performance, key metrics, and issues.

Preferred candidate profile

• Bachelors degree in business, insurance, or a related field (or equivalent experience).
• 5+ years of experience in claims management or a related field, including at least 2 years in a leadership role.
• Strong understanding of insurance policies, claims procedures, and industry regulations.
• Excellent leadership, communication, and interpersonal skills.
• Ability to manage multiple priorities and meet deadlines in a fast-paced environment.
• Proficiency in claims management software and Microsoft Office Suite.