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Claim Processing Analyst
3 weeks ago
Claim Processing Analyst
**Primary Details**
Time Type: Full time
Worker Type: Employee
This role is responsible for end to end claims management of claims. This includes making decisions on claim outcome, declining claims, customer interaction (inbound and outbound), supplier coordination, raising payments to suppliers and claim finalization. This role is also responsible for keeping portfolios compliant to SLAs measured.
**Primary Responsibilities**
- Manage claims end to end within parameters of claims manual, DTPs, policies and relevant legislation and regulations
- Ensure compliance within delegated authority limits
- Maintain effective and proactive communication with customers
- Ensure effective coordination with suppliers
- Set possible cost of claim and updates on time as reports are sent through by assessors
- Raises payment within delegations of authority
- Decide on the best fulfillment method to settle claim
- Identify suspicious or potentially fraudulent claims in accordance with QBE fraud indicators. Refer these claims to the Fraud Investigations team
- Identify recovery opportunities on claims
- Provide information and feedback on claims activity and developing trends to underwriters/risk assessors to enable appropriate actions to be carried out
- Provide feedback to the underwriting team for details that need to be flagged/ noted in the policy that is relevant upon renewal
**Required Education**
- Bachelor's Degree or equivalent combination of education and work experience
**Required Experience**
- NA
**Preferred Competencies/Skills**
- Customer service skills
- Proficiency in MS tools
- Analytical and negotiation skills
- Excellent verbal and written communication skills (English)
- Preferably with Case Management Skills
**Preferred Knowledge**
- Preferred Basic Knowledge of Insurance
- Basic Knowledge of Customer Service
**QBE Cultural DNA**
**US Only - Disclaimer**
- To successfully perform this job, the individual must be able to perform each essential job responsibility satisfactorily. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential job responsibilities.
**Global Disclaimer**
- The duties listed in this job description do not limit the assignment of work. They are not to be construed as a complete list of the duties normally to be performed in the position or those occasionally assigned outside an employee's normal duties. Our Group Code of Ethics and Conduct addresses the responsibilities we all have at QBE to our company, to each other and to our customers, suppliers, communities and governments. It provides clear guidance to help us to make good judgement calls.
How to Apply:
Equal Employment Opportunity:
QBE is an equal opportunity employer and is required to comply with equal employment opportunity legislation in each jurisdiction it operates.
Job ID 324584
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