Claims Examiner II A&H Specialist
hace 4 horas
We are seeking a highly skilled Claims Examiner II A&H Specialist to join our team at AIG. As a key member of our claims function, you will be responsible for investigating, evaluating, negotiating, and settling complex claims cases.
Key Responsibilities:
- Collect and analyze data to determine whether to accept or deny a claim based on all documentation received.
- Manage key claims handling enquiries, coverage determination, quantum analysis, and legal liability assessment for high-value complex claims.
- Ensure effective vendor and litigation management on complex claims within a personal allocation, including demonstrable savings.
- Report key claims messages to the Team Manager and internal stakeholders.
- Communicate with internal and external stakeholders as a technical claims expert and thought leader.
- Deliver technical training to colleagues and external contacts as appropriate.
- Assist in continuous improvement across the region through support for the Quality Assurance/Regional Audit processes.
- Ensure adherence to best practice procedures for complex claims, consistent with global best practice.
Requirements:
- 0-3 years of claims handling or case management experience for medical or personal accident claims portfolios.
- 0-2 years of handling and managing medical service providers' networks, cost containment strategies, and continuous improvement strategies.
- Basic policy wording interpretation and claims resolution on personal accident or medical expenses policies.
- Minimum to medium experience in handling complex case management (e.g., cancer, etc.).
What We're Looking For:
- Effective analytical and attention to detail.
- Excellent communication skills, both written and verbal.
- Good presentation skills and file knowledge.
- Time management – ability to manage and prioritize workload and diary management.
- Ability to contribute effectively within a team environment and with internal/external stakeholders at all levels.
- Ability to assist with technical training to team claim handlers as required.
- Ability to influence claims and non-claims stakeholders to effectively direct claims strategy.
About AIG:
AIG is a global leader in commercial and personal insurance solutions. We are committed to creating a culture that truly respects and celebrates each other's talents, backgrounds, cultures, opinions, and goals. We foster a culture of inclusion and belonging through our flexible work arrangements, diversity and inclusion learning, cultural awareness activities, and Employee Resource Groups (ERGs).
AIG provides equal opportunity to all qualified individuals regardless of race, color, religion, age, gender, gender expression, national origin, veteran status, disability, or any other legally protected categories.
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