Claims SME (Marunji)

Claims SME (Marunji)

05 Sep
|
Recognized
|
Marunji

05 Sep

Recognized

Marunji

Claims SME – Property & Casualty (P&C;) Insurance



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Who are we


Fulcrum Digital is an agile and next -generation digital accelerating company providing digital transformation and technology services right from ideation to implementation. These services have applicability across a variety of industries, including banking & financial services, insurance, retail, higher education, food, healthcare, and manufacturing.


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Experience Required


- 5 to 8 years of end -to -end Property & Casualty (P&C;) claims handling experience.

- Solid expertise in claims adjudication, coverage analysis, liability determination, and claims lifecycle management.

- Experience supporting process transitions, quality initiatives, and operational excellence programs.


Key Responsibilities

- Act as the Subject Matter Expert (SME) for P&C; claims processes, policy coverage, and claims adjudication.

- Provide guidance and support to claims teams on complex claims, coverage interpretation, and liability assessments.

- Review high -value or complex claims to ensure accurate and compliant claim decisions.

- Support quality assurance activities through claim file reviews, audits, and feedback sessions.

- Assist in developing and maintaining Standard Operating Procedures (SOPs), process documentation, and training materials.





- Conduct knowledge -sharing sessions and mentor team members on claims best practices and industry standards.

- Identify process improvement opportunities and support implementation of operational efficiencies.

- Assist with new client transitions, workflow stabilization, and knowledge transfer activities.

- Collaborate with stakeholders to resolve escalations and ensure timely claim resolution.

- Monitor claims trends, identify risks, and recommend corrective actions to improve claim outcomes.

- Support reporting requirements, root cause analysis, and continuous improvement initiatives.


Skills Required

- Deep understanding of Property & Casualty (P&C;) insurance claims, policy coverage, and claims handling practices.

- Strong analytical and problem -solving skills with the ability to evaluate complex claim scenarios.

- Excellent communication and stakeholder management abilities.

- Strong knowledge of claims quality standards, compliance requirements, and operational best practices.

- Experience conducting audits, quality reviews, and process assessments.

- Ability to support training, coaching, and knowledge management initiatives.

- Strong decision -making and escalation management skills.

- Proficiency in Microsoft Excel, PowerPoint, and operational reporting tools.

- Ability to manage multiple priorities in a fast -paced environment.








📌 Claims SME (Marunji)
🏢 Recognized
📍 Marunji

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