Analyst Complex Claims

Analyst Complex Claims

American International Group, Inc. (AIG) is a leading global insurance organization. AIG member companies provide a wide range of property casualty insurance in approximately 70 countries and jurisdictions. These diverse offerings include products and services that help businesses and individuals protect their assets and manage risks. We’re also committed to making a positive difference for our colleagues and in the communities where we work and live. We encourage colleagues to give back to the causes they care most about, supporting these efforts through our Volunteer Time Off and Matching Grants Programs.

Get to know the business

General Insurance is a leading provider of insurance products and services for commercial and personal insurance customers. It includes one of the world’s most far-reaching property casualty networks. General Insurance offers a broad range of products to customers through a diversified, multichannel distribution network. The role of the complex auto claims analyst aims to collaborate with business segments by providing support, technical expertise, and a partnership-based relationship. The diversity of the business portfolio requires the claims analysis team to possess specialized knowledge across various business areas. This team works collaboratively with business units to support a wide range of products and offerings and manages payments to vendors and policyholders, while the team leader plays a pivotal role in guiding the group toward achieving its objectives.

About the role

What you need to know: Managing special accounts, handling 60 new claims per month, coordinating internal and external teams, and improving NPS.

Manage tourist policy cases and complex claims with discipline, ensuring timely follow-up and meeting departmental metrics (102% closing ratio), while handling 60 new claims per month and maintaining an outstanding caseload of 210 claims.

Duties and Responsibilities

1. Functional Responsibilities:

• Utilizes acceptable investigation claims handling and settlement techniques that achieve cost effective and timely closure results by obtaining, reviewing and analyzing documentation, policy provisions and other records. May require additional contact with other parties (i.e. employer, claimants, third parties such as medical providers, auto repair centers, etc.) as deemed necessary. Utilizes diary system to pro-actively resolve outstanding issues and to ensure timely processing and closure of claim.
• Provides timely service throughout the life of the claim by meeting all service level agreements, initiating timely contact to all appropriate parties, and responding to incoming inquires according to company policy and procedures.
• Maintains accurate system data and documentation by collecting, recording, analyzing, and summarizing information.
• Determines and timely sets appropriate reserves within authority level.
• Identify subrogation opportunities and fraud potential and make appropriate referrals.
• Managing key claims handling enquiry; coverage determination, quantum analysis and legal liability assessment, where appropriate within authority limits and providing a high standard of customer service.
• Work with Team Manager/Senior Adjuster to ensuring effective vendor and litigation management on Complex claims within a personal allocation.
• Internal stakeholder communication where required.
• Strive for continuous improvement on claim file handling with feedback and support through the Quality Assurance Review processes.
• Contribute to maintenance of best practice procedures for Auto Complex claims, consistent with global best practice.
• Demonstrate a basic standard of technical claims competence for handling moderate to lower complexity complex claims.
• Handle complex claims allocated within agreed level of authority limit.

2. Accountabilities: Team performance

• Timely, accurate and customer focused claim resolution, minimising indemnity exposure and mitigating vendor and legal expense.
• Effective communication of key Complex claims and Auto portfolio messages to internal stakeholders.
• Financial control through consistent reserve and other financial transaction discipline.
• Accurate and consistent policy interpretation Personal Development / Succession Planning for individuals within the Complex team. Managing compliance with governance standards and regulatory requirements within the Complex team. Effective communication to all relevant stakeholders.

3. Leadership Skills

• People and team management experience, including the proven ability to effectively manage team members.
• Ability to positively influence, in a multi-cultural environment, stakeholders at every level both internally & externally.
• Highly effective communicator (written, verbal, presentation, training).
• Ability to deliver strategic directives internally while also marketing AIG claims expertise externally.
• Identify and address performance issues within the team and body shops.

4. Technical Skills and Expertise

• Fully developed specialist knowledge in (LoB) technical claims topics (as listed over page).
• Policy language skills enabling accurate and consistent policy wording interpretation.
• A strong knowledge tecnical auto appraisal.
• Experience in negotiation, mediation, arbitration and ADR skills Information.

What we’re looking for:

• Experience adjusting lower level complexity claims.
• Ability to prioritize and multi-task effectively in a fast paced environment.
• Ability to communicate information clearly and concisely both verbally and in writing.
• Computer proficiency.
• Acquiring adjuster licenses or related may be required, depending upon country/jurisdictional requirements.
• Requires proficiency in Desk Management, phone ‘etiquette’, time management and dealing with difficult customers.
• A basic knowledge of legal / regulatory and litigation / procedural requirements for their line of business.
• Experience in effectively following up on recommendations from technical claims audits and continuous claim handling improvement.
• Bilingual (fluent in written and conversational English).

At AIG, we value in-person collaboration as a vital part of our culture, which is why we ask our team members to be primarily in the office. This approach helps us work together effectively and create a supportive, connected environment for our team and clients alike.

Enjoy benefits that take care of what matters

At AIG, our people are our greatest asset. We know how important it is to protect and invest in what’s most important to you. That is why we created our Total Rewards Program, a comprehensive benefits package that extends beyond time spent at work to offer benefits focused on your health, wellbeing and financial security—as well as your professional development—to bring peace of mind to you and your family.

Reimagining insurance to make a bigger difference to the world

American International Group, Inc. (AIG) is a global leader in commercial and personal insurance solutions; we are one of the world’s most far-reaching property casualty networks. It is an exciting time to join us — across our operations, we are thinking in new and innovative ways to deliver ever-better solutions to our customers.

At AIG, you can go further to support individuals, businesses, and communities, helping them to manage risk, respond to times of uncertainty and discover new potential. We invest in our largest asset, our people, through continuous learning and development, in a culture that celebrates everyone for who they are and what they want to become.

Welcome to a culture of inclusion

We’re committed to creating a culture that truly respects and celebrates each other’s talents, backgrounds, cultures, opinions and goals. We foster a culture of inclusion and belonging through learning, cultural awareness activities and Employee Resource Groups (ERGs). With global chapters, ERGs are a cornerstone for our culture of inclusion. The talent of our people is one of AIG’s greatest assets, and we are honored that our drive for positive change has been recognized by numerous recent awards and accreditations.

AIG provides equal opportunity to all qualified individuals regardless of race, color, religion, age, gender, gender expression, national origin, veteran status, disability or any other legally protected categories. AIG is committed to working with and providing reasonable accommodations to job applicants and employees with disabilities. If you believe you need a reasonable accommodation, please send an email to Ver el correo electrónico en click.appcast.io.

Functional Area: CL - Claims

AIG SEGUROS MEXICO S.A. DE C.V. As a global risk leader with deep industry expertise and innovative solutions to smartly manage risk, AIG enables our clients’ growth in ways they never thought possible. We also do the same for our colleagues, because we know our people are our greatest strength – the source of every insight, every idea and every innovation. When we’re working as one team to do what’s right for our colleagues and our communities, we can achieve excellence together. We encourage colleagues to give back to the causes they care most about, supporting these efforts through our Volunteer Time Off and Matching Grants Programs.

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