A claims analyst is responsible for reviewing and evaluating claims submitted by customers, ensuring their accuracy, eligibility, and compliance with company policies, by investigating claims, determining validity, and customer settlement (credit) amounts while maintaining detailed records and communicating with team lead for approval.
Review and evaluate customer claims submitted through various channels (e.g., online, phone, mail).
Investigate claims to determine validity and eligibility based on company policies and procedures.
Gather and analyze supporting documentation to support claim decisions.
Determine appropriate settlement (credit) amounts for valid claims.
Maintain accurate and detailed records of all claim activities in the company's database.
Communicate effectively with customers regarding the status of their claims.
Collaborate with team leads to resolve complex claims and escalate issues as needed.
Identify and report potential fraud or abuse.
Stay updated on relevant industry regulations and company policy changes.
Contribute to process improvement initiatives within the claims department.
WFH
Full Time
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Looking for a new challenge as an Accounts Receivable Claims Clerk? Join our dynamic team in this essential role, where you'll play a crucial part in effectively managing customer claims. At our company, we foster an environment that encourages collaboration and innovation. As an Accounts Receivable Claims Clerk, you’ll be tasked with reviewing and evaluating claims submitted by customers from various channels—online, phone, or mail. You’ll dive deep into investigating these claims, determining their validity and eligibility based on our company policies. Your analytical skills will shine as you gather supporting documentation to back up claim decisions, and you’ll determine appropriate settlement amounts for valid claims with a keen eye for detail, maintaining accurate records in our database. Communication is key in this role, as you’ll keep customers updated on their claims' status and collaborate closely with team leads on more complex cases. Spotting potential fraud and contributing to process improvements will also be part of your responsibilities in our ambitious workplace. If you’re ready for a full-time WFH opportunity that offers professional growth while enhancing your skills in claims management, we want to hear from you!
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