Claims Specialist at The Crox Group in New Haven, Connecticut

Posted in Other 2 days ago.

Type: full-time





Job Description:

Key Responsibilities:
  • Review, evaluate, and process insurance claims in a timely manner.
  • Investigate claims by gathering necessary documentation, conducting interviews, and coordinating with relevant parties.
  • Assess coverage, liability, and damages to determine appropriate settlements.
  • Communicate effectively with claimants, policyholders, legal teams, and insurance carriers.
  • Ensure compliance with company policies, insurance regulations, and industry standards.
  • Document and maintain accurate claim records in the company's claims management system.
  • Identify potential fraudulent claims and escalate cases when necessary.
  • Provide claim status updates and resolutions to clients and internal stakeholders.
  • Collaborate with other departments, such as underwriting and legal, to resolve claim disputes.
  • Recommend process improvements to enhance efficiency and customer satisfaction.

Qualifications & Requirements:
  • Bachelor's degree in Business, Insurance, Finance, or a related field (preferred).
  • Proven experience in claims processing, insurance, or a related field.
  • Strong knowledge of insurance policies, claim regulations, and industry best practices.
  • Excellent analytical and problem-solving skills.
  • Strong communication and negotiation abilities.
  • Attention to detail and ability to handle multiple tasks efficiently.
  • Proficiency in claims management software and Microsoft Office Suite.
  • Ability to work independently and as part of a team.

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