(00055) Claims Manager

Description

Job Summary: Analyze, manage, and control insurance claims, ensuring compliance with internal and external policies from initiation through closure. Key Responsibilities: 1. Insurance claim analysis and processing 2. Comprehensive tracking and control of claim processes 3. Alert evaluation and potential fraud detection **Contract Type** -------------------- Indefinite-term contract **Job Description** --------------- Analyze, review, manage, and control reported insurance claims associated with an insurance policy, tracking each claim from initial reporting through to final closure, meeting defined deadlines and providing necessary justifications to comply with the company’s internal policies and external regulatory entities (CMF). **Key Responsibilities** ------------- 1\. Analyze and process claims according to defined procedures. * Review and analyze daily incoming claims received via various reporting channels to activate the Processing Plan. * Contact the insured party and request required documentation. * Evaluate proper registration and assignment of claims to respective files and adjusters based on causes and consequences of each case. * Verify automated alerts—either from SISGEN or those assigned by the Unit—to promptly raise alarms regarding potential conflicts for the Company. * Generate fraud-related alerts and assign potentially fraudulent claims to the appropriate department, subject to prior approval by management, while maintaining continuous information flow with the adjuster. * Review documentation from inspections conducted by the Underwriting Unit on the insured risk (photos, application forms, vehicle documents, and risk descriptions), enabling comparison when required. 2\. Conduct process tracking and control. * Track claims by generating or reviewing file notes and claim calendar entries in the relevant IT system, as well as updating case information timely. * Monitor expert assessments and all stages of the claim management process. * Track and control pending settlement cases—whether delayed by adjusters, repair shops, or suppliers—via review of the IT system. **Education** ------------- Administrative Technician **Experience** --------------- 2 years of experience in related positions within insurance companies **Competencies** ---------------- **Application Deadline** -------------------------------