Company Description:
Sutherland started 33 years ago with the objective of “Helping out clients maximize their customer lifetime value and increase their competitive advantage by helping drive productivity and efficiency while delivering measurable results”. That strategic mission has remained unchanged. Today, we are a digital transformation company and our product is exceptional experiences. Experience to our clients, their customers, their employees and our employees. We combine the front-end customer focused services with optimized back-end processes in an integrated manner along the entire journey map of the customer. This holistic view of our clients’ customers powered with our deep domain knowledge, design thinking, and advanced analytics driven business insights allows us to work exceptionally well with our clients through their digital transformation journey.
Job Description:
CLAIMS HANDLER
•Document claim file by accurately capturing and updating claims data/information in compliance with best practices for low to moderate. exposure and complexity for Property and Content damage and Liability/Injury claims.
•Exercise judgement to determine policy verification and coverage determination by analyzing applicable coverage for claims and determining whether the loss falls within the coverage.
•Exercise judgement to determine liability by gathering and analyzing relevant facts, images; utilizing applicable coverages.
•Identify anomalies and patterns to identify fraudulent claims and refer to SIU team based on SOPs.
•Work to have a timely resolution to claims with complete ownership from initiation/intake to settlement.
•Assess damages by calculating applicable damage or range of damages.
•Negotiate settlement of a claim by establishing the appropriate negotiation strategy and utilizing available resources within authority limits.
•Meet quality standards by following best practices.
•Responsible for data integrity and the appropriate documentation of the claim file as well as for compliance with regulatory requirements.
•Accountability in customer satisfaction and execute on the strategy to provide the best claims service for host damage protection.
•Ensure customer service by proactively communicating information, responding to inquiries, following customer protocols and special handling instructions.
•Ensure legal compliance by following federal laws and regulations, and internal control requirements.
Qualifications:
•Bachelor’s degree or college Diploma.
•Experience in P&C, Healthcare Claims dealing with damage, liability or injury claims.
•Good knowledge of Insurance claims end-to-end value chain activities, challenges and best practices.
•Good knowledge of how to evaluate injuries and damage using market tools and technology.
•General knowledge of the coverages available under the damage protection, liability policy and some common exclusions.
•Results driven, ability to multi-task, pay attention to detail and follow procedures.
•Proven leadership and time management skills in a team environment.
•Good writing, communication and presentation skills.
Additional Information:
All your information will be kept confidential according to EEO guidelines.