claim specialist
- Guide policyholder on how to proceed with a claim.
- Analyse a claim to establish whether it satisfies the conditions or not.
- Uphold relationships and communication with insurance companies and clients.
- Negotiate and ensure fair settlement of valid claims.
claim specialist
- Responsible for overseeing and tracking customer inquiries at the executive level.
- Supported field managers with reviewing and managing independent adjuster handled claim files.
- Assigned to Phase I MI IPM teamCreated and wrote requirements to interface software CPS currently uses to work in IPM.
- Data mined Excel spreadsheets to find trends and to summarize results.
claim specialist
- Resolved complex, severe exposure claims, using high service oriented file handling.
- Maintained claim files such as records of settled claims and an inventory of claims requiring detailed analysis.
- Investigated, evaluated and settled claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio.
- Managed pivot table projects which contain provider claim discrepancies on CMS 1500 and UB-04 forms, in a timely manner resolution complete.
- Created Policies and Procedures for Claims review
claim specialist
- Investigates, evaluates, negotiates, and settles auto claims in an assigned area.
- Verifies coverage, legal liability and extent of damage to persons and property
- Uses various electronic resources for claim handling
- Applies knowledge of policies, procedures, laws, statutes and insurance regulations when determining coverage, liability, and property damage
- Interview or correspond with claimants, witnesses, police, or other relevant parties to determine claim settlement, denial, or review.Examine claims forms and other records to determine insurance coverage.