Claims Specialist

• Determine covered failures by reviewing vehicle service agreements, interpreting policy coverage, and researching facts across automobiles, recreational vehicles, and power sports
• Determine the need for inspections
• Provide claim adjudication and problem resolution in the VPS Contact Center
• Respond to and resolve client and customer issues through inbound and outbound calls, email, fax, and chat
• Ensure customer and client requests receive timely responses and meaningful solutions
• Gain and maintain in-depth knowledge of VPS products, clients, systems, and applications
• Ensure compliance with ISO, SOX, PCI, applicable audits, and contractual obligations
• Adjust and document claims according to departmental standards, applicable laws, policy provisions, and Department of Insurance regulations
• Process claims accurately by reviewing contracts and web-based applications, resolving complex issues, and escalating matters when necessary
• Adjudicate claims by working with repair facilities, inspection and parts vendors, and other resources
• Document claim denial or authorization reasons and quote policy language to the appropriate parties
• Participate in training programs, quality assessments, and personal performance management planning

Claims Specialist jobs in India

Associate Auto Claims Adjuster