Claims Officer

Job Title: Claims Officer. Location: Vedanayagam Hospital. Job Type: Full Time Contact: 8825809203 Key Responsibilities Claims Processing: Review and process incoming claims to ensure they meet the required criteria. Assess the validity of claims based on policy terms, conditions, and evidence. Determine the appropriate settlement amount and communicate the decision to the claimant or insured. Investigation & Documentation: Gather relevant information, including medical records, police reports, and witness statements. Investigate potential fraudulent claims by conducting interviews, reviewing evidence, and collaborating with other departments (e.g., legal, fraud detection). Ensure that all necessary documentation is obtained and properly filed. Customer Communication: Communicate with claimants, policyholders, and third parties to provide updates and explanations about the claims process. Address customer inquiries and concerns professionally and efficiently. Compliance & Reporting: Ensure compliance with internal policies, industry standards, and regulatory requirements. Prepare and maintain accurate claims files, reports, and records. Provide regular updates to management on claims statuses and performance. Claims Settlement: Approve or deny claims based on thorough analysis and in accordance with company policies. Negotiate settlements with claimants or legal representatives when necessary. Coordinate payments, settlements, or resolutions as appropriate. Team Collaboration: Work closely with other departments, such as legal, underwriting, and customer service, to ensure a smooth claims process. Participate in team meetings to discuss claims trends, issues, and process improvements. Continuous Learning: Stay up-to-date with changes in industry regulations, insurance products, and claims management best practices. Participate in ongoing professional development to enhance knowledge and skills. Job Types: Full-time, Permanent Compensation: 15,000.00 - 20,000.00 per month Benefits Food provided Provident Fund Experience: total work: 2 years (Required) Work Location: In person .