• Receive and check claims document, enter data/information into Claim system, send claim to assessors in charge, allocate and filing claim documents.
• Maintains quality claims services by following customer service practices; responding to customer inquiries.
• Meet with clients/agents and witnesses to gather information regarding claim.
• Ensures legal compliance by following company policies, procedures, guidelines, as well as and insurance regulations.
• Determines the covered insurance losses by studying provisions of policy or certificate.
• Establishes proof of loss by studying medical documentation; assembling additional information as required from outside sources, including claimant, physician, employer, hospital, and other insurance companies; initiating or conducting investigation of questionable claims.
• Protects operations by keeping claims information confidential and prepares reports by collecting, analyzing, and summarizing information.
• Updates job knowledge by participating in educational opportunities; reading professional publications; maintaining personal networks; participating in professional organizations.
• Accomplishes departmental as well as organization goals by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments.
• Others tasks assigned by Head of Departments