About the role
Join a passionate team at Great Eastern to redefine the role of a claim professional. You will be responsible for the accurate and timely assessment of life insurance claims, ensuring fair outcomes in accordance with policy terms, service standards, and regulatory requirements while contributing to service excellence initiatives.
InsuranceOnsiteClaims
Key Responsibilities
- Assess and approve life claims and appeals accurately within established turnaround times, adhering to policy provisions and authority limits.
- Evaluate medical, financial, and supporting claim documentation to ensure appropriate claim decisions and reserve adequacy.
- Manage complex claim investigations and appeals, including seeking clarification from medical institutions, policyholders, and internal stakeholders.
- Review pending claims to ensure timely resolution and proper closure.
- Identify claim patterns and unusual practices, recommending improvements to strengthen claims controls and streamline processes.
- Collaborate with medical institutions, policyholders, and internal stakeholders to gather and clarify necessary information.
- Provide clear, empathetic, and timely communication to policyholders, claimants, agents, and medical professionals.
- Adhere strictly to internal policies and external regulatory requirements while mitigating business and compliance risks.
Requirements
- Proven ability to assess life insurance claims accurately and in a timely manner.
- Strong analytical skills with attention to detail regarding medical and financial documentation.
- Ability to manage investigations and appeals processes effectively.
- Excellent communication skills for engaging with diverse stakeholders (policyholders, doctors, internal teams).
- Commitment to maintaining high standards of customer service and transparency.
- Knowledge of life insurance claims processes and regulatory compliance is essential.