Claims Adjuster

We are seeking a Claims Adjuster responsible for managing, evaluating, and resolving insurance claims in accordance with policy terms, legal requirements, and Coface Group guidelines. This role ensures accurate claims processing, timely indemnity payments, and a high level of client satisfaction through a proactive, customer-centric approach.

The Claims Adjuster will investigate claims, assess coverage, analyze relevant data, and make decisions within their delegated authority. You will also provide recommendations on complex cases and collaborate with internal and external stakeholders to achieve fair and efficient outcomes.

Key Responsibilities

Claims Handling

• Review and analyze claim documentation to determine coverage eligibility.

• Investigate claims and evaluate supporting data to ensure accurate decisions.

• Communicate findings and negotiate outcomes with internal and external stakeholders.

• Escalate and propose next steps for claims exceeding delegated authority.

• Maintain accurate and up-to-date claim reserves using internal systems.

• Prepare and process indemnity payments in a timely manner in accordance with delegation levels.

• Partner with legal advisors, underwriters, and other experts on complex claims.

• Provide documentation to support debt collection efforts or legal proceedings.

• Continuously monitor the status and progress of all assigned claims.

• Identify recovery opportunities, including subrogation, and take action to maximize recoveries.

• Participate in projects and transformation initiatives as assigned.

Customer Service

• Serve as the primary point of contact for clients and brokers, prioritizing phone communication when possible.

• Respond to inquiries, resolve disputes, and provide regular claim status updates.

• Build and maintain strong relationships with policyholders, brokers, and partners.

• Clearly explain claim decisions, including non-covered claims.

• Facilitate and lead claims discussions or meetings with stakeholders as needed.

• Provide guidance and support on claims management and settlement processes.

• Collaborate with the Debt Collection team to determine optimal recovery strategies.

• Drive improvements in customer satisfaction through timely, accurate, and professional communication.

Compliance

• Conduct investigations with a focus on fraud prevention.

• Ensure adherence to all applicable legal, regulatory, and internal compliance requirements.