Claims Analyst II

hace 4 semanas

Mexico City AIG A tiempo completo
Claims Analyst

The primary purpose of the job is to investigate, evaluate, negotiate and settle the most complex of the AIG Complex Claims cases by  collecting and analyzing data according to policy application and/or contract provisions.  Determine whether to accept or deny a claim based on all documentation received. Typical claims include: policy cancelations due to non-pay denial letter required

Your contribution at AIG

The employee will handle a monthly average of 45 claims new and 135 oustanding  according to the staffing model

Primary Responsibilities:

  • Utilizes acceptable investigation claims handling and settlement techniques that achieve cost effective and timely closure results by obtaining, reviewing and analyzing documentation, policy provisions and other records.  May require additional contact with other parties (i.e. employer, claimants, third parties such as medical providers, auto repair centers, etc.) as deemed necessary.  Utilizes diary system to pro-actively resolve outstanding issues and to ensure timely processing and closure of claim.
  • Provides timely service throughout the life of the claim by meeting all service level agreements, initiating timely contact to all appropriate parties, and responding to incoming inquires according to company policy and procedures. 
  • Maintains accurate system data and documentation by collecting, recording, analyzing, and summarizing information. 
  • Determines and timely sets appropriate reserves within authority level.
  • Identify subrogation opportunities and fraud potential and make appropriate referrals.
  • Managing key claims handling enquiry; coverage determination, quantum analysis and legal liability assessment, where appropriate within authority limits  and providing a high standard of customer service.
  • Work with Team Manager/Senior Adjuster to ensuring effective vendor and litigation management on Complex claims within a personal allocation.
  • internal stakeholder communication where required
  • Strive for continuous improvement on claim file handling with feedback and support through the Quality Assurance Review processes
  • Contribute to maintenance of best practice procedures for Auto Complex claims, consistent with global best practice.
  • Demonstrate a basic standard of technical claims competence for handling moderate to lower complexity complex claims.
  • Handle complex claims allocated within agreed level of authority limit

Accountabilities:

  • Timely, accurate and customer focused claim resolution, minimising indemnity exposure and mitigating vendor and legal expense
  • Effective communication of key Complex claims and Auto portfolio messages to internal stakeholders.
  • Financial control through consistent reserve and other financial transaction discipline
  • Accurate and consistent policy interpretation

What we are looking for

  • Experience  adjusting  lower level complexity claims
  • Ability to prioritize and multi-task effectively in a fast paced environment.
  • Ability to communicate information clearly and concisely both verbally and in writing.
  • Computer proficiency.
  • Acquiring adjuster licenses or related may be required, depending upon country/jurisdictional requirements.
  • Requires proficiency in Desk Management, phone ‘etiquette’ , time management and dealing with difficult customers.
  • A basic knowledge of legal / regulatory and litigation / procedural  requirements for their line of business.
  • Experience in effectively following up on recommendations from technical claims audits and continuous claim handling improvement.
  • Bilingual (fluent in written and conversational English)

#LI-MF1

#LI-AIG

Reimagining insurance to make a bigger difference to the world

American International Group, Inc. (AIG) is a global leader in commercial and personal insurance solutions; we are one of the world’s most far-reaching property casualty networks. It is an exciting time to join us — across our operations, we are thinking in new and innovative ways to deliver ever-better solutions to our customers. At AIG, you can go further to support individuals, businesses, and communities, helping them to manage risk, respond to times of uncertainty and discover new potential. We invest in our largest asset, our people, through continuous learning and development, in a culture that celebrates everyone for who they are and what they want to become.

Welcome to a culture of belonging

We’re 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). With global chapters, ERGs are a cornerstone for our culture of inclusion. The diversity of our people is one of AIG’s greatest assets, and we are honored that our drive for positive change has been recognized by numerous recent awards and accreditations.

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.

Functional Area:

CL - Claims

Estimated Travel Percentage (%): No Travel

Relocation Provided: No

AIG SEGUROS MEXICO S.A. DE C.V.

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