Insurance Claims Resolution Specialist
hace 3 días
The primary purpose of this position is to investigate, evaluate, negotiate, and settle complex claims cases for AIG by collecting and analyzing data according to policy application and/or contract provisions.
Responsibilities:- Utilize acceptable investigation claims handling and settlement techniques to achieve cost-effective and timely closure results.
- Obtain, review, and analyze documentation, policy provisions, and other records as necessary.
- Make timely contact with other parties, including employers, claimants, and third-party providers, to ensure effective resolution.
- Maintain accurate system data and documentation by collecting, recording, analyzing, and summarizing information.
- Determine and set appropriate reserves within authority limits.
- Identify subrogation opportunities and fraud potential, making referrals as needed.
This role involves handling a monthly average of 45 new claims and 135 outstanding claims. The employee will work closely with the team manager/senior adjuster to ensure effective vendor and litigation management on complex claims within their allocated authority limits.
Required Skills and Qualifications:- Experience adjusting lower-level complexity claims.
- Ability to prioritize and multitask effectively in a fast-paced environment.
- Effective communication skills, both verbal and written.
- Computer proficiency, including desk management, phone etiquette, time management, and dealing with difficult customers.
- A basic knowledge of legal, regulatory, and litigation/procedural requirements.
- Experience in determining liability and following up on recommendations from technical claims audits.
AIG offers a comprehensive benefits package, including competitive salary, health insurance, retirement plan, and paid time off. The company also provides opportunities for continuous learning and development, celebrating individual talents, backgrounds, cultures, opinions, and goals.
AIG is committed to creating a culture of belonging, inclusion, and diversity. The company fosters a culture that respects and celebrates each other's differences, providing flexible work arrangements, diversity and inclusion learning, cultural awareness activities, and Employee Resource Groups (ERGs).
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