Claims Analyst ll

Posted:
10/14/2024, 1:17:27 PM

Location(s):
Mexico City, Mexico

Experience Level(s):
Junior ⋅ Mid Level

Field(s):
Customer Success & Support ⋅ Sales & Account Management

Claims Analyst II

Who we are?

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 claims function is meant to be a partner to the business segments, offering support, expertise and partnership. The existing diversity of the business portfolio demands from the claims role specialized expertise in the different business areas. The Auto claims team works with all key stakeholders (internal and external) to guarantee an adequate Total Cost of Claim and the best service possible por individual and corporate claims.

About the role

The primary purpose of the job is to investigate, evaluate, negotiate and settle the most complex of the AIG Complex Claims cases by  collecting and analyzing data according to policy application and/or contract provisions.  Determine whether to accept or deny a claim based on all documentation received. Typical claims include: policy cancelations due to non-pay denial letter required

 Your contribution at AIG 

The employee will handle a monthly average of 45 claims new and 135 oustanding  according to the staffing model 

 Primary 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

Accountabilities: 

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

 What we are 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.

·Experience in determining of liability (claims)

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 belonging

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 our flexible work arrangements, diversity and inclusion learning, cultural awareness activities and Employee Resource Groups (ERGs). With global chapters, ERGs are a cornerstone for our culture of inclusion. The diversity 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 [email protected].  

Functional Area:

CL - Claims

Estimated Travel Percentage (%): No Travel

Relocation Provided: No

AIG SEGUROS MEXICO S.A. DE C.V.

American International Group

Website: https://aig.com/

Headquarter Location: New York, New York, United States

Employee Count: 10001+

Year Founded: 1919

IPO Status: Public

Industries: Commercial Insurance ⋅ Financial Services ⋅ Health Insurance ⋅ Insurance ⋅ Lending ⋅ Life Insurance ⋅ Property Insurance ⋅ Real Estate Investment ⋅ Retirement ⋅ Risk Management