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Position Summary: Process claims files to ensure effective and high-quality resolution in customer service, maintaining up-to-date regulatory knowledge. Key Responsibilities: 1. Manage claims and service files. 2. Ensure customer service quality. 3. Maintain up-to-date knowledge of procedures and regulations. **Contract Type** -------------------- **Description** --------------- Perform management and processing activities for claims files across various coverages, guarantees, and services within the assigned business line, arising from insurance or non-insurance contracts, in compliance with applicable regulations, contractual conditions, technical standards, and supervisory guidelines, to ensure accurate and efficient file resolution in terms of cost and timeline while meeting service and quality objectives in customer and policyholder support. **Responsibilities** ------------- * Maintain current, innovative, specific, and/or specialized knowledge of procedures, regulations, technical criteria, etc., within one's area of responsibility through participation in training sessions and monitoring of key performance and quality indicators. * Process assigned claims or service files at one's level, in accordance with unit guidelines and procedures, ensuring high-quality service to policyholders to minimize complaints and claims. * Analyze incoming documentation to determine claim coverage based on the affected contractual condition and the insured's agreement, conduct initial valuation, notify policyholders, and request, where necessary, additional information or documentation required for proper processing. * Conduct daily review of departmental incoming documentation (customer letters, opposing company letters, opposing company expert reports, settlement documents, expert opinions), and respond to calls from customers, agents, experts, and claimants to provide service and information regarding claims files within one's scope, facilitating file resolution while ensuring service quality. * Assign damage assessment/responsibility valuation tasks to the appropriate professional/expert and review related reports; verify, where applicable, their suitability to ensure optimal and efficient technical support for claims resolution and detection of potential fraud for specific handling. * Manage, at one's level, payment of workshop and customer invoices, and, where applicable, pursue payments from debtor firms and/or propose settlements to policyholders, lawyers, and insurance companies; and, if applicable, execute corresponding disbursements of such amounts to ensure claims resolution under optimal time and cost conditions for the unit or Group, within one's area of competence. **Education** ------------- **Experience** --------------- **Competencies** ---------------- Insurance Sector Knowledge of insurance operations Fraud management in insurance Claims knowledge Customer relationship management Supplier management Customer service policies, standards, and procedures Claims management Claims frequency analysis**Application Deadline** -------------------------------
