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Insurance Claims Consultant
3 months ago
The Bilingual Claims Consultant will oversee designated claims and client accounts with a focus on efficiency and effectiveness by assessing and proactively aiding clients in improving their claims processes. The Claims Consultant will conduct client evaluations and assist with industry presentations/internal initiatives as necessary.
Key Responsibilities:- Claims Evaluation:
- Execute expert claims evaluation adhering to internal guidelines, authorized limits, and client response deadlines.
- Assess coverage matters, ensuring timely identification, resolution, and communication of issues.
- Investigate and analyze claim discrepancies proactively.
- Authorize payments in line with established protocols and client service agreements.
- Maintain organized claim documentation and manage follow-up processes effectively.
- Client Relations:
- Build and sustain positive, mutually beneficial relationships with clients through professional communication.
- Track client claim performance and provide timely, accurate information to business partners through data analysis and reporting.
- Assist in identifying and implementing strategies to enhance claims handling efficiency.
- Formulate and execute plans to address declining client claim outcomes.
- Risk Assessment and Reviews:
- Interpret contractual language with a solid understanding of the group insurance sector and best practices in claims management.
- Identify and report exceptions to reinsurance treaty terms and claims non-compliance to internal stakeholders, offering resolution recommendations.
- Conduct client audits in accordance with reinsurance treaty agreements and generate analytical reports with actionable insights.
- Engage in presentations of client review outcomes and follow up on suggested actions for improvement.
- Present claims to Senior Management for assessment, including comprehensive claim summary reports and high-risk claim notifications.
- Knowledge Sharing:
- Design and deliver training sessions and presentations for clients and internal teams through seminars or publications.
- Provide advanced knowledge of insurance claims investigations and practices to clients and colleagues, applying emerging risk management insights.
- Collaborate with pricing, underwriting, and legal teams to ensure compliance with treaty obligations and client decisions align with risk standards.
- Project Coordination:
- Contribute to product development, treaty wording, industry surveys, and special projects as required.
- Bachelor's degree in health sciences, psychology, criminology, business, or a related field.
- LOMA or other relevant insurance designations (NIDMAR, CEBS) are preferred.
- At least 2 years of experience in insurance claims (short- and long-term disability required; health or dental experience is a plus).
- Demonstrated attention to detail and accuracy in claims evaluations and data management.
- Strong analytical skills and a commitment to meeting deadlines and deliverables.
- Self-motivated with a proven ability to work independently.
- Willingness to learn about various lines of business and claim types.
- Excellent skills in presentation and report generation.
- Strong verbal and written communication abilities.
- Proven track record of building solid client relationships.
- Experience in group insurance, reinsurance, underwriting, medical concepts, or financial analysis is advantageous.
- Bilingual proficiency in French is required.
- Willingness to travel as necessary.
We provide our employees with comprehensive benefits and resources to support their overall well-being, including:
- A collaborative work environment that fosters continuous learning and development.
- A hybrid work model combining in-office and remote work with designated focus periods.
- A competitive compensation package with annual bonuses.
- Comprehensive health and dental benefits starting from day one.
- Flexible spending options for health and wellness.
- Immediate enrollment in a pension plan with employer contributions.
- Generous time-off policies including vacation, personal days, and holidays.
- Access to professional development resources and programs.
- Support for maternity, parental, and adoption leave.
- Employee recognition and rewards programs.
At Munich Re, we are committed to helping society navigate risks with courage and innovation. As a leading global reinsurance provider, we leverage our expertise to transform uncertainty into manageable risk. We prioritize diversity, inclusion, and belonging, fostering a culture that embraces diverse perspectives. Our strategic investments in technology and talent empower us to drive significant change in the insurance landscape.
We appreciate your interest in joining our team and encourage qualified candidates to apply. Munich Re is dedicated to creating an inclusive work environment and will provide accommodations for applicants with disabilities throughout the recruitment process.
