Key skills
CAgileStakeholder ManagementCommunication
About this role
Claims SME – Property & Casualty (P&C) Insurance
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.
Experience Required
- 5 to 8 years of end-to-end Property & Casualty (P&C) claims handling experience.
- Strong 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.