Claims Operations Specialist

Exp-5-10 Years

Relevant in Exp-5 Years

Location-Remote

Shift-4PM-1AM/ 5PM-2AM/Rotational

Job Description: Operations Claims

Experience - 5 - 10 yrs

• Business acumen
• Data analysis and Excel proficiency
• Digital/technology fluency
• Problem-solving and analytical thinking
• Ability to work with ambiguity
• Strong written and oral communication skills
• Reviewed potential future responsibilities which may including TPA Reconciliation, Executive Lines support, FNOL, and other complex claims functions. Experience in the US Property and Casualty domain required.
• Need candidates with relevant insurance experience and strong communication skills.

Responsibilities –

• Perform First Notice of Loss (FNOL) intake and setup with accuracy, completeness, and timeliness.
• Handle or support handling of multiple loss type claims, including:
• Auto
• General Liability
• Workers Compensation
• Property
• Cyber
• Apply working knowledge of coverages across the above loss types to support claim setup, investigation, and administration.
• Review policy information to confirm applicable coverage, limits, deductibles, exclusions, endorsements, and jurisdictional considerations.
• Conduct initial claim triage and ensure assignment to the appropriate claim professional when needed.
• Coordinate with insureds, brokers, claimants, attorneys, vendors, adjusters, and internal business partners.
• Support reserve setting and reserve adjustments based on claim facts and exposure evaluation.
• Identify potential severity, litigation, fraud, subrogation, and recovery opportunities and escalate as appropriate.
• Provide professional and timely communication to all stakeholders throughout the claim lifecycle.