Specialist

Job description

Description and Requirements Insurance Associate (Specialist) Position Title

Specialist (EB Claims - Assessor)

Reports to (Responsibility Level)

Process Supervisor (Assistant Manager / Unit Manager)

Supervises

NA Location: Jaipur Global Grade: GG 9 Complexity: PID/s Load Mapping:

Position Summary

The role will predominantly be working on Employee Benefits claims

Job Responsibilities

• Responsible for the timely and accurate assessment, decision making, settlement and communication of Employee Benefits Claims from beginning to end. These claims will be from our Group Life insurance products.
• Act independently within agreed authority and service levels. Decision making authority is an essential requirement.
• Provide exceptional levels of customers service to policyholders, clients and intermediaries in a professional and friendly manner.
• Identify and investigate potential fraudulent claims.
• Identify process issues and propose solutions for improvement within agreed business framework.
• Liaising with the underwriters and external service providers to ensure all appropriate information is obtained to assist in the assessment and ongoing management of claims.
• Manage claim appeals within agreed process and authority level. Education, Technical Skills & Other Critical Requirement Education Bachelor’s degree (Any Stream) or diploma with a minimum of 15 years of education.

Experience (In Years) Candidates should have a strong background in Claims management and/or administration with 3+ years’ experience. Demonstrate a strong customer focus, with passion for ensuring the customer receives the right support and solutions

Technical Skills

Confident and decisive when analyzing information and determining outcomes. Excellent written and verbal communication skills. Excellent customer service skills. Excellent inter-personal skills, with the ability to liaise with people at all levels. Ability to work efficiently with good attention to detail. Confident, calm with a professional telephone manner. Ability to apply empathy and be sympathetic as well as resilient.

Accurate and able to demonstrate a high level of organization. Ability to multi-task and prioritize workload. Ability to multiple systems Self-motivated, enthusiastic with a ‘can do attitude’. Good team player with the ability to work on own initiative. A good understanding of compliance, legal and FCA regulations (full MetLife Corporate training will be provided) AI Fluency - Working knowledge of Microsoft Copilot Other Critical Requirements Like Voice/ Non-Voice for Insurance Ops Non-Voice Rule & non-rule-based decision making, domain knowledge, extensive customer communication (Email only)