Claims Executive Resume
Objective : As a Claims Executive, ensured all claims and correspondence, on delegated authority cases, were correctly maintained and provided a clear and concise history of events, actions, and quantum assessment.
Skills : Claims Management, Insurance Expertise.
Description :
- Undertaken inquiries necessary to obtain sufficient information to establish policy liability and progress claims efficiently.
- Registered new claims accurately on the company computer systems and updated the records during the life of the claim.
- Obtained and submitted completed Client claim documentation to Insurers or nominated service providers promptly.
- Answered telephone calls promptly and effectively dealing with all inquiries professionally and efficiently.
- Processed incoming posts within agreed service standards.
- Dealt with Client enquiries within designated time frames.
- Processed claims competently within the stipulated turnaround time and in accordance with claims protocol.
Experience
0-2 Years
Level
Entry Level
Education
Bachelor's Degree in Business
Claims Executive Resume
Summary : As a Claims Executive, provides claims handling services to an allocated portfolio of clients while supporting the overall claims service provision to clients, and supporting associates within the team.
Skills : Negotiation Skills, Analytical Skills.
Description :
- Dispatched claim settlement cheques on the date of receipt.
- Maintained an up-to-date daily diary system.
- Managed claims to a conclusion, liaising effectively and appropriately with the client, insurer, loss adjuster, and any other interested party.
- Provision of advice on the application of policy cover and the necessary documentation/information required to progress the claim.
- Negotiated with insurers to achieve the most beneficial and cost-effective settlement for the client.
- Negotiated with insurers to ensure reserves are realistic and appropriate.
- Ensured claims are registered and appropriately updated on our systems.
Experience
10+ Years
Level
Senior
Education
Bachelor's Degree in Insurance
Claims Executive Resume
Summary : As a Claims Executive, communicated effectively with Insurers, nominated service providers, engineers, and Loss Adjusters Providing advice and assistance to Clients, to actively manage the claim process.
Skills : Customer Service, Communication Skills.
Description :
- Attended internal and external meetings as required.
- Reported any major or sensitive claims to the Account Executive responsible.
- Understood the appropriate claims notification and investigation procedures applicable to each class of insurance.
- Understood the insurance program and service plans for an allocated portfolio of clients and documented client-specific claim-handling arrangements for internal purposes.
- Provided feedback for insurer review meetings and actively contributed to the development of relationships.
- Built and nurtured close, long-lasting relationships by developing a constantly expanding network of client, insurer, lawyer, and loss adjuster contacts.
- Prepared and maintained client claim experiences.
Experience
7-10 Years
Level
Management
Education
Bachelor's Degree in Insurance
Claims Executive Resume
Objective : As a Claims Executive, presents claims to underwriters, deals with queries, provides feedback, and responds appropriately to clients, insurers, and relevant internal departments.
Skills : Problem-Solving, Legal Knowledge.
Description :
- Gathered and processed information, as directed, to support the effective assessment of more complex cases.
- Assisted in the training of new or inexperienced staff in the use of company systems and processes.
- Reported to the Claims Operations Manager on workflow issues and the handling of assigned claims inventory.
- Performed claims reviews and loss analysis for assigned threshold accounts.
- Collated claims statistics/data for management reporting.
- Countersigned claim executives' offer to process claims.
- Handled claims appeals and complaints of customers.
Experience
2-5 Years
Level
Executive
Education
Bachelor's Degree in Insurance
Claims Executive Resume
Summary : As a Claims Executive, reviews and prepares correspondence regarding notifications and claims to ensure that products and cover best meet the clients risk requirements, business objectives, and compliance requirements.
Skills : Excellent negotiation, Conflict resolution abilities.
Description :
- Processed claims according to policy's terms and benefits to determine the amount of the claim payable.
- Provided on-the-job training for newcomers to enhance team competency in handling portfolios.
- Provided technical guidance and advice on all claims and settlements to both client and team members.
- Inputted and maintained claims data onto the Acturis platform, ensuring that files were accurate, compliant, and processed in a timely manner and that diaries were kept up to date.
- Advised on, handled, and resolved Claims matters by phone, email, and in person as appropriate.
- Delivered great customer service by responding swiftly to queries and concerns from clients, ensuring service standards were always met.
- Organized and attended claims meetings both internally and with Clients as required.
Experience
7-10 Years
Level
Consultant
Education
Bachelor's Degree in Insurance
Claims Executive Resume
Objective : As a Claims Executive, support the team in providing an effective and efficient claims service to our customers. Dealing effectively with all claims allocated, ensuring that company policy, procedure, and regulatory requirements are always adhered to.
Skills : Leadership, Team management.
Description :
- Fostered and maintained professional relationships with Insurers and other suppliers.
- Documented claims files by accurately capturing and updating claims data/information in compliance with best practices for single and multi-party personal or commercial line claims of moderate complexity and exposure.
- Exercised judgment to determine liability by gathering and analyzing relevant facts, utilizing applicable law, and establishing basic principles of negligence.
- Exercised judgment to determine policy verification and coverage determination by analyzing applicable coverage for claims and determining whether the loss falls within the coverage.
- Worked to have a timely resolution to claims by developing a case strategy, developing a case evaluation, and escalating issues as appropriate.
- Established timely reserves and performed ongoing reviews throughout the claims cycle within authority limits by estimating and validating the value of claims.
- Assessed damages by calculating applicable damages or the range of damages allowed by law.
Experience
0-2 Years
Level
Junior
Education
Bachelor's Degree in Insurance
Claims Executive Resume
Objective : As a Claims Executive, responsible for a designated caseload handling claims from cradle to grave and liaising extensively with clients, Insurers, claimants, policyholders, brokers, and other experts.
Skills : Customer service, Negotiation.
Description :
- Negotiated settlement of claim by establishing appropriate negotiation strategy and utilizing available tools and resources within authority limits.
- Ensured customer service by proactively communicating information, responding to inquiries, following customer protocols, and participating in customer marketing efforts.
- Managed litigation by assigning counsel within the approved panel where applicable, establishing litigation plan and budget.
- Coordinated defense lawyer activities, continuously reviewing the potential for settlement with claimants, reviewing litigation expenses, and authorizing payments.
- Managed expenses by working within vendor-approved networks and managing the scope of work assigned to outside contractors.
- Ensured legal compliance by following state and federal laws and regulations and internal control requirements.
- Referred claim to subrogation and fraud teams by identifying potential subrogation and fraud.
Experience
0-2 Years
Level
Fresher
Education
Bachelor's Degree in Business
Claims Executive Resume
Summary : As a Claims Executive, handles all claims proactively properly addressing all coverage issues, liability, and damages to timely set reserves and mitigate the exposures. Maintains adjuster licenses where required, is current with all continuing education requirements, and attends internal and external industry-related educational programs.
Skills : Denial, Analysis, Collaboration.
Description :
- Contributed to profitable growth by providing risk insight, information, and trends to the Business Unit or customer as needed.
- Anticipated, recognized, and responded timely to inquiries to ensure customer satisfaction.
- Collected data and documents in established systems including commentary and an analysis of trends to facilitate decision-making.
- Acquired and organize the relevant evidence and information to accurately assess the value of the claim.
- Analyzed data using pre-determined tools, methods, and formats and made recommendations in order to support the department’s timely resolution of claims.
- Provided technical advice that enables a customer to solve a problem or improve business.
- Adhered to local regulatory and governance requirements throughout the life of a claim to ensure decisions are made using the right standards.
Experience
7-10 Years
Level
Consultant
Education
Bachelor's Degree in Business
Claims Executive Resume
Objective : As a Claims Executive, responsible for providing high-level technical claim handling and support to clients and insureds. Mitigates losses, addresses and resolves coverage issues, and when appropriate, provides guidance and advice to internal and external clients and insureds.
Skills : Claims Processing, Compliance.
Description :
- Identified and resolved problems by referring to policies, procedures, and standards to ensure consistency and quality of solutions.
- Assessed and appointed claims vendors within agreed authority limits aligned to the organization´s Claims Vendor Management strategy.
- Assessed and evaluated claims handling processes and systems in order to identify opportunities for improvements.
- Identified training needs and mentored lower-level staff to build on the capabilities of the team.
- Facilitated the claims procedure between the insurance companies, loss adjusters, lawyers, clients, and relevant parties by evaluating, negotiating, and settling the resolution of all classes of claims.
- Managed customer interactions in an efficient, courteous, and timely manner in order to deliver high standards of customer satisfaction.
- Monitored the status of the claims and provided updates to the manager.
Experience
2-5 Years
Level
Executive
Education
Bachelor's Degree in Insurance
Claims Executive Resume
Summary : As a Claims Executive, responsible for monitoring the assigned inventory of accounts, answering phone calls, and consulting on claims-related issues. This includes handling customer service calls as needed and reviewing claims on an as-needed basis.
Skills : Management Skills, Interpersonal Skills.
Description :
- Interpreted the insurance policy and applied the terms and conditions to the exposures presented with each assigned claim.
- Registered claims accurately and timely to ensure all data was captured within the relevant platforms.
- Provided updated claim reports internally and to customers.
- Advised clients on general queries and insurance issues.
- Provided accurate and efficient adjudication of claims, validation, and pre-authorization of applications.
- Attended to claims inquiries and correspondences relating to feedback or complaints promptly and effectively.
- Investigated potential fraudulent claims and reported any suspicion of an irregularity to the superior.
Experience
7-10 Years
Level
Consultant
Education
Bachelor's Degree in Insurance
