SME-Ins Claims

Job Summary

This hybrid subject matter expert role in insurance claims is designed to provide precise, timely support for customer service and domain-driven activities within a multinational organization. The selected professional will evaluate claims, advise stakeholders on process details, and ensure consistent compliance with established standards while working rotational shifts with no travel required. By improving claim handling quality and operational performance, this position helps strengthen customer confidence across the organization’s insurance services portfolio.

Responsibilities

Review incoming insurance claims and related customer service requests to confirm coverage, identify documentation gaps, and ensure every case is processed correctly according to internal guidelines and domain standards.

Manage customer service conversations across multiple channels to deliver clear updates on claim status, required next steps, and expected resolution timelines, while maintaining a composed, empathetic communication approach.

Partner with internal operations teams to improve claim intake and assessment workflows, and drive better turnaround times and lower rework through thorough case reviews.

Complete end-to-end documentation audits for claim files to verify information is complete, consistent, and compliant with process requirements, preventing downstream processing problems.

Examine claim information using available systems and tools to identify potential inconsistencies, and escalate complex or unclear cases through the defined escalation procedures.

Provide organized feedback on recurring customer service concerns and claim processing challenges to help product and process owners refine procedures and service scripts.

Contribute to continuous improvement by tracking key performance indicators related to claim resolution accuracy, customer satisfaction scores, and cycle time, and by recommending practical enhancements.

Work with training and quality teams by sharing real-world case examples and insights from day-to-day work to support stronger learning content and quality assurance checklists.

Enhance the knowledge base by writing clear process notes and frequently asked questions that help colleagues resolve claims and customer questions more efficiently.

Effectively manage a rotational shift schedule by handling workload intelligently and sustaining reliable responsiveness and quality across all shift timings.

Apply hybrid work practices responsibly by ensuring secure and confidential handling of sensitive claim information both on-site and remotely, in line with company policies.

Support the company purpose by guiding customers through stressful claim situations with clarity and fairness, reinforcing trust in the organization and its insurance service offerings.

Participate in cross-functional meetings to represent claims and customer service viewpoints, ensuring that operational improvements positively affect end customers and broader society through dependable risk protection.

Qualifications

Provide proof of solid experience in insurance claims domain work, with two to four years of hands-on involvement in processing or supporting claims operations in a professional environment.

Demonstrate strong customer service capabilities, including active listening, accurate communication, and effective issue resolution that supports high customer satisfaction and reduces repeat contacts.

Use baseline knowledge of property and casualty insurance concepts—including policy coverage limits, deductibles, exclusions, and claim life cycle—to interpret case details accurately.

Show competence in standard office productivity tools and claims-related applications used to log cases, update records, and create straightforward reports for stakeholders.

Exhibit flexibility for both hybrid work and rotational shifts by planning tasks efficiently, managing time-sensitive demands, and maintaining consistent performance levels.

Demonstrate analytical judgment and strong attention to detail when reviewing claim facts and customer information to support accurate decisions and equitable outcomes for all parties.

Maintain a willingness to learn new processes, regulatory changes, and system enhancements in the insurance domain, and apply new learning to improve daily execution.

Certifications Required

Preferred certifications include insurance claims or customer service credentials such as INS or AIC or equivalent industry-specific training.