The Insurance Claims Officer plays a crucial role in the retail and healthcare sectors by managing and processing insurance claims efficiently. This position requires a detail-oriented individual who can navigate complex insurance policies and ensure that claims are handled in a timely and accurate manner. The ideal candidate will possess strong analytical skills and a customer-focused approach to service delivery.

Responsibilities:

1. Review and assess insurance claims for accuracy and completeness.
2. Communicate with clients to gather necessary documentation and information.
3. Investigate claims by gathering evidence and liaising with relevant parties.
4. Ensure compliance with company policies and regulatory requirements.
5. Maintain detailed records of claims processing and outcomes.
6. Provide support to clients throughout the claims process, addressing any concerns or questions.
7. Collaborate with other departments to resolve complex claims issues.
8. Analyze trends in claims data to identify potential areas for improvement.
9. Prepare reports on claims activity for management review.
10. Stay updated on changes in insurance regulations and industry standards.

Preferred Candidate:

1. Strong analytical and problem-solving skills.
2. Excellent communication and interpersonal abilities.
3. Detail-oriented with a focus on accuracy.
4. Ability to work independently and as part of a team.
5. Proficient in using claims management software and Microsoft Office.
6. Customer service-oriented mindset.
7. Ability to handle sensitive information with confidentiality.
8. Knowledge of insurance policies and procedures.
9. Adaptability to changing environments and processes.
10. Proven ability to meet deadlines and manage multiple tasks.

Skills

• Strong knowledge of insurance claims processes and regulations.
• Proficiency in claims management software.
• Excellent written and verbal communication skills.
• Strong organizational and time management abilities.
• Ability to analyze data and generate reports.
• Customer service skills to assist clients effectively.
• Attention to detail and accuracy in documentation.
• Problem-solving skills to address claims issues.