Senior Claims Analyst

hace 2 semanas

Ciudad de México, Ciudad de México AIG A tiempo completo
Senior Claims Analyst - A&H Company Overview

American International Group, Inc. (AIG) stands as a prominent global insurance provider. Our member companies deliver a comprehensive array of property and casualty insurance solutions across approximately 70 countries and jurisdictions. We pride ourselves on offering products and services that empower businesses and individuals to safeguard their assets and effectively manage risks.

We are dedicated to fostering a positive impact within our teams and the communities we serve. Our commitment to social responsibility is reflected in our Volunteer Time Off and Matching Grants Programs, encouraging our colleagues to engage with causes they are passionate about.

Understanding the Business

General Insurance is recognized as a leading supplier of insurance products and services tailored for both commercial and personal clients. Our extensive property casualty network is among the most expansive globally. We provide a diverse range of products through a multifaceted distribution network.

The claims department plays a crucial role in supporting various business segments, offering expertise and collaboration. Given the diverse nature of our business portfolio, claims professionals are required to possess specialized knowledge across different sectors. The A&H claims team collaborates closely with the business to manage a wide range of products, navigating a complex and demanding distribution framework. Our claims team is responsible for fulfilling the promises made to our clients, particularly in sensitive and intricate situations that significantly impact the health and well-being of our insured individuals.

Role Overview

Key Responsibilities:

The primary objective of this position is to thoroughly investigate, assess, negotiate, and resolve complex claims cases by gathering and analyzing relevant data in accordance with policy applications and contractual terms. You will determine the validity of claims based on the documentation provided. Typical claims may involve policy cancellations due to non-payment and require denial letters.

Your Impact at AIG

The individual in this role will manage an average of 60 new claims monthly, alongside 60-90 ongoing claims, in line with our staffing model.

Core Duties and Responsibilities

1. Functional Responsibilities:

  • Overseeing key claims inquiries; determining coverage, analyzing quantum, and assessing legal liability for high-value complex claims.
  • Ensuring effective management of vendors and litigation for complex claims within personal allocations, demonstrating measurable savings.
  • Communicating key claims insights to the Team Manager and relevant internal stakeholders.
  • Engaging with internal and external stakeholders as a technical claims expert and thought leader.
  • Delivering technical training to colleagues and external partners as necessary.
  • Supporting continuous improvement initiatives across the region by aiding Quality Assurance and Regional Audit processes.
  • Adhering to best practice procedures for complex claims, consistent with global standards.
  • Managing higher complexity claims within established authority limits.

2. Accountabilities:

  • Ensuring timely, accurate, and customer-centric claim resolutions, minimizing indemnity exposure and controlling vendor and legal expenses.
  • Effectively communicating and managing advanced complex claims and portfolio messages to internal stakeholders and clients.
  • Maintaining financial discipline through consistent reserve management and other financial transactions.
  • Providing accurate and consistent interpretations of policy language.
  • Developing expertise in complex claims management while also mentoring and supporting management responsibilities.

3. Leadership Skills:

  • Exceptional written and verbal communication abilities.
  • Strong presentation skills and comprehensive file knowledge.
  • Effective time management skills to prioritize workload and manage schedules.
  • Ability to collaborate effectively within a team and engage with stakeholders at all levels.
  • Capability to assist in technical training for claims handlers as needed.
  • Influencing skills to guide claims strategy among stakeholders.

4. Technical Skills and Expertise:

  • Advanced knowledge in complex claims topics relevant to the line of business.
  • Proficient in policy language interpretation for accurate and consistent application.
  • Basic to intermediate understanding of legal, regulatory, and procedural requirements for the line of business.
  • Experience in negotiation, mediation, arbitration, and alternative dispute resolution for high-value complex claims is advantageous.
  • Familiarity with following up on recommendations from technical claims audits and enhancing file handling processes.
Qualifications
  • Experience:
    • 0-3 years in claims handling or case management for medical or personal accident claims.
    • 0-2 years managing medical service provider networks and implementing cost containment strategies.
    • Basic understanding of policy wording interpretation and claims resolution for personal accident or medical expense policies.
    • Experience in handling complex case management scenarios.
  • In addition to technical skills, soft skills such as effective broker engagement, teamwork, proactive claims management, and strong time management are essential.

Attention to detail and analytical skills are crucial for success in this role.

Transforming Insurance for a Greater Impact

American International Group, Inc. (AIG) is a global leader in commercial and personal insurance solutions, with one of the most extensive property casualty networks worldwide. We are committed to innovative approaches that enhance our offerings to customers. At AIG, you will have the opportunity to support individuals, businesses, and communities in managing risks and navigating uncertainties.

Embracing a Culture of Inclusion

We are dedicated to fostering a culture that values and celebrates diverse talents, backgrounds, and perspectives. Our commitment to inclusion is reflected in our flexible work arrangements, diversity training, cultural awareness initiatives, and Employee Resource Groups (ERGs). The diversity of our workforce is one of AIG's greatest strengths, and we are proud to have received recognition for our efforts in promoting positive change.

AIG is an equal opportunity employer, providing opportunities to all qualified individuals regardless of race, color, religion, age, gender, gender expression, national origin, veteran status, disability, or any other legally protected category.

Functional Area:

CL - Claims

Estimated Travel Percentage (%): No Travel

Relocation Provided: No

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