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Claims Associate Responsibilities and Duties

Evaluate all claim and policy information and investigate all details for insured client for various line of business and ensure applicable coverage of individual.

Perform interviews and gather all statements from insured clients, physicians and attorneys for all claim information and evaluate all facts for policy contracts.

Investigate and prepare reports for all denials of claims and settlements and provide update on all files and recommend reserve changes to all claims.

Evaluate progress for all claims and coordinate with team leader for all issues and effective resolution and develop new methods to handle all claims.

Administer and settle all claims effectively and inform all customers and claimants for any denial on claims.

Coordinate with team leader and attorneys and prepare all cases for trials and record all statements of witnesses and participate in all claim file review and audits.

Maintain records of all benefits and resolve all issues in claim processes to minimize risks in claims processes and maintain records of all shipments and storage.

Manage and distribute all incoming mails and perform research on all claim numbers and utilize all automated computer systems.

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