Claims Analyst - Property and Casual Insurance

• 1.         Job Function

The
  Claims Analyst – Workmen’s Compensation is responsible
  for processing and settling workmen’s compensation claims promptly and
  accurately, within levels of authority, in an efficient workflow, and in
  accordance with company practices and procedures. Report complaints and
  irregularities to management and compliance. Discuss with Third Parties and
  insurers on matters of subrogation. Refer and confer on litigation matters
  with management and attorneys.
  All activities must conform to organizational
  guidelines and standards and to all legal, statutory, regulatory and treaty requirements.

2.         Principal Duties and Responsibilities

• Possesses a strong working knowledge of all product classes and services of

• Verify and analyze data used in settling claims to ensure that claims are valid.

•  Enter new claims and information on computer system (INSUR)e nsuring
    that data is concise yet sufficient for file documentation.

• Examine and discuss claims that are being investigated and adjusted by providers. Provide recommendation to management.

• Adjust reserves or provide recommendations to ensure that reserve activities are consistent with corporate practices.

•   Investigate, evaluate and settle claims, applying technical knowledge and human relations skill to
    effect fair and prompt disposal of cases within designated authority levels.

• Interview clients, claimants, experts, employers and providers to get additional information. Present cases and participate in their discussion at claim committee meetings.

• Maintain files such as an inventory of claims, subrogation files and follow ups and detailed analysis to closure.

• Identify complex problems, review related information to develop and evaluate options and make recommendations to management.

• Issue Management Alert Report (MAR)

• Issue Reinsurance Loss Notice

• Advises insurers of Third-Party claims reported and records settled claims.

• Write and follow up Third Parties and Insurers to closure on Subrogation matters.

• Actively applies and delivers all customer service standards and core beliefs by demonstrating professionalism, promptness, accuracy, courtesy and helpfulness.

•  Supports the development and maintenance of a team environment by performing other
    related duties.

• Adheres  to Anti-Money laundering guidelines

3.         Personal Attributes

• Sound  Judgment
• Detail oriented
• Customer oriented
• Good Listener
• Problem-Solving
• Negotiator
• Strong communicator
• Time-Management
• Learning & Comprehension

4.         Qualifications
  and Experience

• Five (5) G.C.E. /C.X.C.

• Two (2) A levels

• Diploma Claims Administration or Diploma Claims Adjusting/Investigation, or at least three (3) years experience in Claims OR an Equivalent combination of working experience and education

5.         Knowledge,
  Skills and Abilities

• Working knowledge of all classes of insurance including Reinsurance
• Knowledge of the structure and content of the English Language including the meaning and spelling of words, rules of composition and grammar
• Knowledge of Arithmethic, methods of calculation and statistics and their applications.
• Knowledge of the principles and processes for providing customer and personal services. This includes customer needs, quality standards for services and evaluation of customer satisfaction.
• Knowledge of administrative and clerical procedures and procedures such as managing files and records, office procedures and terminology
• Knowledge of Computer Hardware and Software including applications and programming
• Knowledge of laws governing the Insurance Industry, civil proceedings regulations, opinions/precedents affecting the insurance industry.

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