Job Title: Claims Officer.
Location: Vedanayagam Hospital.
Job Type: Full Time
Contact: 8825809203
Key Responsibilities:
- Claims Processing:
- Review and process incoming claims to ensure they meet the required criteria.
- Assess the validity of claims based on policy terms, conditions, and evidence.
- Determine the appropriate settlement amount and communicate the decision to the claimant or insured.
- Investigation & Documentation:
- Gather relevant information, including medical records, police reports, and witness statements.
- Investigate potential fraudulent claims by conducting interviews, reviewing evidence, and collaborating with other departments (e.g., legal, fraud detection).
- Ensure that all necessary documentation is obtained and properly filed.
- Customer Communication:
- Communicate with claimants, policyholders, and third parties to provide updates and explanations about the claims process.
- Address customer inquiries and concerns professionally and efficiently.
- Compliance & Reporting:
- Ensure compliance with internal policies, industry standards, and regulatory requirements.
- Prepare and maintain accurate claims files, reports, and records.
- Provide regular updates to management on claims statuses and performance.
- Claims Settlement:
- Approve or deny claims based on thorough analysis and in accordance with company policies.
- Negotiate settlements with claimants or legal representatives when necessary.
- Coordinate payments, settlements, or resolutions as appropriate.
- Team Collaboration:
- Work closely with other departments, such as legal, underwriting, and customer service, to ensure a smooth claims process.
- Participate in team meetings to discuss claims trends, issues, and process improvements.
- Continuous Learning:
- Stay up-to-date with changes in industry regulations, insurance products, and claims management best practices.
- Participate in ongoing professional development to enhance knowledge and skills.
Job Types: Full-time, Permanent
Pay: ₹15,000.00 - ₹20,000.00 per month
Benefits:
- Food provided
- Provident Fund
Experience:
- total work: 2 years (Required)
Work Location: In person
