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The Claims Specialist is responsible for efficiently processing and reviewing claims while ensuring compliance with company policies, regulatory requirements, and agreed service levels (SLAs). This role includes handling customer queries related to claims, providing timely updates, and offering solutions to any issues that may arise. The Claims Specialist is also tasked with investigating potential fraud, adjudicating claims fairly, and supporting internal teams with ad hoc tasks. Additionally, this role requires effective collaboration with multilingual customer service teams, assisting with the development of new products, and driving continuous improvements to processes.
What you will do as a Claims Specialist in Companjon
* Process claims within the agreed company SLA, ensuring each claim is assessed in accordance with company policies, industry regulations, and best practices.
* Conduct thorough and fair adjudication of claims, performing investigations and following up with customers and internal departments in a timely manner.
* Address external and internal customer queries in a professional, solution-oriented manner.
* Provide language support (including but not limited to French, German, Italian, Spanish, Hungarian) to assist customer service teams with claims-related complaints and complex cases.
* Collaborate with tech and IT teams in the development and refinement of claims processing products.
* Conduct Special Investigation Unit (SIU) reviews and escalate potential fraud cases for further investigation.
* Generate and analyze recurring claims reports to identify trends, operational efficiencies, and areas for improvement.
* Maintain training materials and ensure team members are updated on best practices and procedural changes.
* Perform other ad hoc duties as required to support the claims and Customer Service department and business objectives.
What you will need to succeed
* Possession of one of the following qualifications: APA (Personal General Insurance), CIP, Accredited Product Professional, Associate or Fellow of the Chartered Insurance Institute.
* Previous experience in a claims handling, insurance, or related field preferred.
* Knowledge of insurance policies and claims adjudication processes.
* Experience in fraud detection and escalation is a plus.
What we would love to see from you
* Strong analytical and decision-making skills.
* Excellent communication and customer service skills.
* Ability to manage multiple tasks and prioritize effectively.
* Strong attention to detail and accuracy.
* Problem-solving and investigative mindset.
* Proficiency in multiple languages is an advantage.
* Experience with claims processing systems and technology.
* Fluent in English and one other language.
Companjon is a leading tech venture in Europe specialising in embedded insurance that’s fully digital, end-to-end, and hassle-free. Our highly successful business model allows us to partner with global digital businesses to bring their customers unique, flexible, and fully automated insurance tailored to their bookings and purchases.
Our motto: Right there when life happens!
Seniority level
* Associate
Employment type
* Full-time
Job function
* Information Technology and Finance
* Insurance
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