Operations Claims

Who are we

Fulcrum Digital is an agile and next-generation digital accelerating company providing digital transformation and technology services right from ideation to implementation. These services have applicability across a variety of industries, including banking & financial services, insurance, retail, higher education, food, healthcare, and manufacturing.

About the role

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.