Escalates moderate to complex issues pertaining to claims complications and claims process to ensure application of pertinent policy and action calculation of claims rates.
Maintains and generates claims reports of moderate complexity, to ensure accurate records are produced and distributed.
Updates, generates, reviews, and distributes new claim notifications/ updates, to all insurers for all policies or coverages, with and without the use of predefined templates, to ensure consistent availability of up-to-date information to team until completion of claim.
Reviews and files incoming documentation from clients and underwriters, seeking guidance or advice where necessary, to ensure that client and insurer-related materials are catalogued, distributed, and readily available to the team.
Acknowledges receipt of documentation by mail or phone to maintain ongoing and professional communication with insurers, clients, and underwriters.
Enters or updates claims information into appropriate claims application(s)
on a timely basis and in compliance with any local service standards to maintain accurate records for Claims Advisory.
Prepares insurance claims forms or related documents according to standard templates and reviews them for completeness to support professional staff in their communications with clients and insurers.
Calls or writes to insured or other involved persons for missing or supplemental information and posts or attaches information to claim file to ensure proper follow up correspondence is being maintained.
Identifies potential policies and coverages for incoming claims, seeks validation where necessary, and advice where uncertain or clarification required in order to prepare for the proper processing of claims.
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