Claims Assessor

Job description

Job Purpose: The Claims Assessor plays a critical role in defining the company’s liability under credit insurance contracts. This position involves managing a portfolio of complex claims, ensuring timely and accurate claim assessments, and delivering excellent service to policyholders and brokers. The role requires a strong understanding of policy conditions, legal frameworks, and commercial sensitivity, as well as effective collaboration across departments such as Collections and Commercial.

Key Repsonsibilities:

• Analyze insurance claims to determine coverage, liability, and validity based on policy terms.
• Review and interpret policy conditions, risk data, and debt documentation.
• Request and evaluate additional documentation or clarifications from policyholders or brokers.
• Communicate assessment decisions and next steps clearly and professionally.
• Handle claim appeals and resolve complaints from policyholders or brokers.
• Collaborate with the Collections team to verify the adequacy of collection efforts and policy compliance.
• Respond promptly to internal and external inquiries through the Claims Helpdesk.
• Apply commercial gestures authorized by the Commercial department and escalate contractual issues when needed.
• Maintain detailed and accurate records and documentation throughout the claim lifecycle.
• Support process improvement initiatives, knowledge sharing, and departmental training.
• Run all claims-related reports and analyze data to identify trends, bottlenecks, and opportunities for improvement.
• Act as a super user for the claims management system: support testing, identify bugs, lead implementation of new features, and train team members on system updates and best practices

Key Experience:

Market knowledge

• Knowledge of Claims and Collections processes and systems
• Knowledge of Quality Standards , C&C operational guidelines
• Ability to identify mandatory documents per type of claims / collection
• Understanding of claims reporting requirements, tools, and performance indicators
• Familiarity with claims systems architecture and functionality; ability to act as a super user to support upgrades, troubleshoot issues, and train others

Required Skills

• Strong interpersonal and communication skills.
• Comfortable with numbers; strong analytical skills.
• Strong attention to detail.
• Ability to determine te appropriate course of action in assessing claims
• Result oriented & Team player
• Customer centric

Key Requirements:

• Bachelor’s Degree in Business Administration or a relevant field.
• 3-5 years experience in claims assessment with insurance company
• Excellent communication skills in English, both spoken and written
• Advanced Excel skills