Claims Analyst Ll
vor 1 Monat
Claims Analyst II Who we are?
American International Group, Inc. (AIG) is a leading global insurance organization.
AIG member companies provide a wide range of property casualty insurance in approximately 70 countries and jurisdictions.
These diverse offerings include products and services that help businesses and individuals protect their assets and manage risks.
We're also committed to making a positive difference for our colleagues and in the communities where we work and live.
We encourage colleagues to give back to the causes they care most about, supporting these efforts through our Volunteer Time Off and Matching Grants Programs.
Get to know the business
General Insurance is a leading provider of insurance products and services for commercial and personal insurance customers.
It includes one of the world's most far-reaching property casualty networks.
General Insurance offers a broad range of products to customers through a diversified, multichannel distribution network.
The claims function is meant to be a partner to the business segments, offering support, expertise and partnership.
The existing diversity of the business portfolio demands from the claims role specialized expertise in the different business areas.
The Auto claims team works with all key stakeholders (internal and external) to guarantee an adequate Total Cost of Claim and the best service possible for individual and corporate claims.
About the role
The primary purpose of the job is to investigate, evaluate, negotiate and settle the most complex of the AIG Complex Claims cases by collecting and analyzing data according to policy application and/or contract provisions.
Determine whether to accept or deny a claim based on all documentation received.
Typical claims include: policy cancellations due to non-pay denial letter required.
Your contribution at AIG
The employee will handle a monthly average of 45 new claims and 135 outstanding claims according to the staffing model.
Primary Responsibilities:
Utilizes acceptable investigation claims handling and settlement techniques that achieve cost effective and timely closure results by obtaining, reviewing and analyzing documentation, policy provisions and other records.
May require additional contact with other parties (i.e.
employer, claimants, third parties such as medical providers, auto repair centers, etc.)
as deemed necessary.
Utilizes diary system to pro-actively resolve outstanding issues and to ensure timely processing and closure of claims.
Provides timely service throughout the life of the claim by meeting all service level agreements, initiating timely contact to all appropriate parties, and responding to incoming inquiries according to company policy and procedures.
Maintains accurate system data and documentation by collecting, recording, analyzing, and summarizing information.
Determines and timely sets appropriate reserves within authority level.
Identifies subrogation opportunities and fraud potential and makes appropriate referrals.
Manages key claims handling inquiries; coverage determination, quantum analysis, and legal liability assessment, where appropriate within authority limits and providing a high standard of customer service.
Works with Team Manager/Senior Adjuster to ensure effective vendor and litigation management on Complex claims within a personal allocation.
Internal stakeholder communication where required.
Strives for continuous improvement on claim file handling with feedback and support through the Quality Assurance Review processes.
Contributes to maintenance of best practice procedures for Auto Complex claims, consistent with global best practice.
Demonstrates a basic standard of technical claims competence for handling moderate to lower complexity complex claims.
Handles complex claims allocated within agreed level of authority limit.
Accountabilities:
Timely, accurate and customer focused claim resolution, minimizing indemnity exposure and mitigating vendor and legal expense.
Effective communication of key Complex claims and Auto portfolio messages to internal stakeholders.
Financial control through consistent reserve and other financial transaction discipline.
Accurate and consistent policy interpretation.
What we are looking for: Experience adjusting lower level complexity claims.Ability to prioritize and multi-task effectively in a fast-paced environment.Ability to communicate information clearly and concisely both verbally and in writing.Computer proficiency.Acquiring adjuster licenses or related may be required, depending upon country/jurisdictional requirements.Requires proficiency in Desk Management, phone etiquette, time management and dealing with difficult customers.A basic knowledge of legal/regulatory and litigation/procedural requirements for their line of business.Experience in effectively following up on recommendations from technical claims audits and continuous claim handling improvement.Functional Area:
CL - Claims
Estimated Travel Percentage (%):
No Travel
Relocation Provided:
No
AIG SEGUROS MEXICO S.A. DE C.V.
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