Claims Analyst

Pay rate range - $25/hr. to $28/hr.
Fully Onsite

Description:

Key Responsibilities:

Managed and processed 200-300 warranty, product damage, logistics, and customer reimbursement claims monthly , ensuring compliance with client policies and service-level agreements (SLAs).
Reviewed claim documentation, invoices, proof of purchase, service reports, and supporting evidence to determine claim validity and eligibility.
Conducted detailed investigations of disputed or complex claims, identifying root causes and recommending appropriate resolutions.
Validated claim accuracy by analyzing product, customer, retailer, and service center information to minimize errors and fraudulent activities.
Collaborated with customer service teams, authorized service centers, logistics providers, retailers, and internal stakeholders to resolve claim issues efficiently.
Adjudicated claims by interpreting policy guidelines, warranty terms, and contractual agreements while maintaining regulatory and company compliance.
Maintained claim records and updated claim management systems with accurate claim status, payment details, and resolution notes.
Performed financial reconciliation and verification of claim payouts, credits, and reimbursements to ensure payment accuracy.
Monitored claim aging, backlog, and performance metrics to meet productivity and quality targets.
Analyzed claim trends and recurring issues, providing recommendations to improve operational efficiency and reduce claim volumes.
Investigated exceptions, escalations, and denied claims, communicating findings and resolutions to affected stakeholders.
Generated periodic reports and dashboards on claim volumes, approval rates, denial reasons, turnaround times, and financial impact.
Supported internal and external audit activities by ensuring documentation completeness and adherence to established controls.
Identified process improvement opportunities that enhanced claim processing accuracy, reduced turnaround time, and improved customer satisfaction.
Assisted in training new team members on claim procedures, systems, and compliance requirements.