索赔审查员 II - MSI
Claims Examiner II - MSI
为什么选择MSI？我们热衷于解决挑战。
作为领先的MGA，MSI将深厚的承保专业知识与保险公司的风险承受能力相结合，为分销合作伙伴提供专业保险解决方案，以满足客户独特的需求。
我们热衷于为个人和企业面临的重大风险打造解决方案。我们提供不断扩展的产品组合——从全数字化嵌入式租房保险到高价值的房屋保险，再到复杂的商业保险，如网络责任险和居住类财产险——通过代理、经纪人、批发商和其他品牌合作伙伴进行交付。
我们的合作伙伴和客户依赖于我们专业的团队，确保快速解决问题，提供优质服务。我们通过先进的技术平台简化保险体验，支持保单生命周期的每个阶段。带来你的挑战，让我们展示我们如何更好地构建保险。
理赔审查员II被认为是处理保单持有人保险理赔的专家，负责处理复杂程度较高的理赔。理赔审查员II必须具备保险理赔处理的技术知识和为客户提供优质服务所需的技能。能够与多样化的客户、保险公司和同事建立关系并有效沟通是该职位成功的关键因素。具有战略眼光并能执行战术以实现目标和宗旨的结果也对本职位的整体成功至关重要。
主要职责：
• 分析保险政策和其他文件以确定保险覆盖范围。
• 调查和分析理赔信息以确定责任范围。
• 处理复杂程度较高的第一方财产理赔。
• 协助诉讼、调解和仲裁。与法律顾问合作应对诉讼。
• 按照公司的准备金理念及时、充分地设立准备金。
• 聘请专家协助评估理赔。
• 监控供应商表现并控制费用成本。
• 评估、协商并确定赔偿金额。
• 在理赔整个过程中与所有相关方沟通。主动与相关方讨论保险覆盖决定、需要额外信息以及赔偿金额。
• 按照最佳实践处理所有理赔。
• 对...负责
查看英文原文
Why MSI? We thrive on solving challenges.
As a leading MGA, MSI combines deep underwriting expertise with insurer risk capacity to create specialized insurance solutions that empower distribution partners to meet customers’ unique needs.
We have a passion for crafting solutions for the important risks facing individuals and businesses. We offer an expanding suite of products – from fully-digital embedded renters coverage to high-value homeowners insurance to sophisticated commercial coverages, such as cyber liability and habitational property – delivered through agents, brokers, wholesalers and other brand partners.
Our partners and customers count on us to deliver exceptional service through a dedicated team that makes rapid resolutions a priority. We simplify the insurance experience through our advanced technology platform that supports every phase of the policy lifecycle. Bring on your challenges and let us show you how we build insurance better.
The Claims Examiner II is considered an expert in managing insurance claims for our policyholders, handling claims with a higher level of complexity. The Claims Examiner II must have technical knowledge in insurance claims handling and the skills needed to provide superior service for our customers. The ability to develop relationships and effectively communicate with a diverse range of clients, carriers and colleagues is a key success factor in this role. Strategic vision coupled with tactical execution to achieve results in accordance with goals and objectives is also critical to the overall success of this position.
PRIMARY RESPONSIBILITIES:
• Analyzes insurance policies and other documents to determine insurance coverage.
• Investigates and analyzes claim information to determine extent of liability.
• Handles claims 1st Party Property Claims of a high level of complexity.
• Assist in suits, mediations and arbitrations. Works with Counsel in the defense of litigation.
• Sets timely, adequate reserves in compliance with the company’s reserving philosophy.
• Engages experts to assist in the evaluation of the claim.
• Monitors vendor performance and controls expense costs.
• Evaluates, negotiates and determines settlement values.
• Communicates with all interested parties throughout the life of the claim. Proactively discusses coverage decisions, the need for additional information, and settlement amounts with interested parties.
• Handles all claims in accordance with Best Practices.
• Responsible for monitoring and completing assigned claims inventory.
• Acquire and maintain a state adjuster’s license and meet state continuing education requirements.
• Provides Best-In-Class customer service for insureds and agents.
• Updates and maintains the claim file.
- Identifies opportunities for subrogation and ensures recovery interests are protected.
- • Identifies fraud indicators and refers files to SIU for further investigation.
- • Participates in claims audits, internal and external.
- • Provides oversight of TPAs
EDUCATION & EXPERIENCE:
High School/GED
5-9 years' experience in claims
Must have Property & Casualty Insurance License
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Originally posted on Himalayas