GSSC Claims Officer
Manila - Philippines
Job Summary
Primary Details
Time Type: Full timeWorker Type: EmployeeThis role is responsible for end-to-end claims management. This includes making decisions on claim outcome declining claims customer interaction (inbound and outbound) supplier coordination raising payments to suppliers and claim finalization. This role is also responsible for keeping portfolios compliant to SLAs measured.Primary Responsibilities
Manage claims end-to-end within parameters of claims manual DTPs GSSC policies and relevant legislation and regulations.
Ensure compliance within delegated authority limits
Maintain effective and proactive communication with customers
Ensure effective coordination with suppliers
Set possible cost of claim and updates on time as reports are sent through by assessors Raises payment within delegations of authority
Interpreting policy coverage and determining if coverages apply to claims submitted. Promptly informing customer of acceptance/ decline of claim and escalating issues or proper endorsement as needed.
Decide on the best fulfillment method to settle claim.
Identify suspicious or potentially fraudulent claims in accordance with QBE fraud indicators. Refer these claims to the Fraud Investigations team.
Identify recovery opportunities on claims
Provide information and feedback on claims activity and developing trends to underwriters/risk assessors to enable appropriate actions to be carried out
Provide feedback to the underwriting team for details that need to be flagged/ noted in the policy that is relevant upon renewal.
Complete uploading and allocation activities to triage documents and claims to the relevant teams (Claims settlements)
Utilize appropriate settlement strategies and tactics for the best commercial outcomes by achieving KPI target (Claims settlements)
Review claim documents to identify cases where liability is disputed for triage to the appropriate claims officers (Claims settlements)
Seeking continuous process policy and procedure improvement alongside keeping up to date with current and new compliance requirements (Claims settlements) Required Education
Bachelors Degree or equivalent combination of education and work experience Required Experience
NA
Preferred Competencies/Skills
Customer service skills
Proficiency in MS tools
Analytical and negotiation skills
Excellent verbal and written communication skills (English)
Preferably with Case Management Skills
Preferred Knowledge
Preferred Basic Knowledge of Insurance
Basic Knowledge of Customer Service QBE Cultural DNA
Everything we do at QBE is underpinned by our DNA (which interlinks seven cultural elements) because we know its not just what we do that matters its how we do it that makes the difference. We expect all employees to role model and inspire the right behaviours that link to our cultural elements:
We are customer-focused
We are technical experts
We are inclusive
We are fast-paced
We are courageous
We are accountable
We are a team
All employees are expected to adhere to QBEs Code of Ethics and Conduct and apply sound risk management practices
US Only - Disclaimer
To successfully perform this job the individual must be able to perform each essential job responsibility satisfactorily. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential job responsibilities. Global Disclaimer The duties listed in this job description do not limit the assignment of work. They are not to be construed as a complete list of the duties normally to be performed in the position or those occasionally assigned outside an employees normal duties. Our Group Code of Ethics and Conduct addresses the responsibilities we all have at QBE to our company to each other and to our customers suppliers communities and governments. It provides clear guidance to help us to make good judgement calls.
Skills:
Analytical Thinking Claims Administration Claims Resolution Collaboration Tools Communication Critical Thinking Customer Service Customer Value Management Financial Advising Intentional collaboration Managing performance Process Compliance Process Improvements Risk Management Stakeholder ManagementHow to Apply:
To submit your application click Apply and follow the step by step process.
Equal Employment Opportunity:
QBE is an equal opportunity employer and is required to comply with equal employment opportunity legislation in each jurisdiction it operates.
Required Experience:
Unclear Seniority
About Company
QBE Insurance Group is one of the world's top 20 insurance and reinsurance companies, located in 26 countries. Visit us for company information.