Claims Analyst

Description

Job Summary: Claims Analyst responsible for documentary and regulatory analysis of indemnity events, deadline management, communication with stakeholders, and monitoring of legal proceedings and auctions. Key Highlights: 1. Documentary and regulatory analysis for indemnity events 2. Process management and communication with all involved parties 3. Monitoring of legal proceedings and vehicle removal • Documentary analysis: Police report (BO), statements from involved parties, driver's license (validity, demerit points, and category permitting vehicle operation), incident notification, dates, consistency of provided information, authenticity of documents, etc.; • Regulatory analysis: Compliance with regulatory standards, active or inactive membership status, payment compliance, coverage under contracted products, possible confrontations conducted in person or by phone; • Upon opening indemnity events, initially review all documentation and its authenticity, and perform any necessary follow-ups within a maximum of three business days after opening, recording all actions accordingly; • Contact the vehicle owner whenever necessary to update information and record all updates; • Request supplementary documentation from the vehicle owner within the regulatory timeframe for scheduling indemnity payment, and record all actions; • Receive supplementary documentation, record it in the system, and conduct a detailed re-analysis to verify the authenticity of the incident; • At any stage of the process, request and analyze internal investigations (sindicâncias) whenever necessary, record all actions, monitor deadlines, inform involved parties, and maintain proper records; • Whenever necessary, request and analyze legal support, record all actions, monitor and control deadlines, and inform all involved parties; • In case of missed deadlines, follow up with involved parties (e.g., return of internal investigations, legal analyses, auction house procedures, etc.); escalate difficulties to the manager and record all actions; • Monitor and update all cases handled by the legal department, conducting periodic follow-up (e.g., judicial and extrajudicial proceedings, recovery actions, etc.); • Extract SGA reports and determine required follow-up actions per case, e.g., legal analysis, denial analysis, indemnity analysis, judicial proceedings, etc.; • Provide support to members or third parties (in person or via phone) whenever necessary to clarify doubts, conduct confrontations, address requests, etc.; • Ensure adherence to indemnity process deadlines as stipulated by regulations and internal policies; • Request and monitor vehicle removal from its origin to the auction house whenever necessary (comparing before-and-after photos; if anomalies are identified, escalate to the manager); • Monitor and ensure all vehicles directed to the auction house are sold as soon as possible, regularly updating the manager and recording progress of all processes in the system; • Consult vehicle data in public, private, and other systems prior to indemnity payment to verify whether the vehicle has been located or if any adverse situation exists; • Coordinate with Finance to schedule the indemnity payment date, communicate with involved parties, and record all information in operational systems; • Forward the case to Finance for scheduling and payment of indemnity, or for reimbursement requests when applicable; • Monitor vehicles undergoing glass repair, from initiation through delivery; • Communicate with the member at every stage of the process. Minimum Education: Elementary School (1st level) * SENAC Partnership * POP Services Discount * Partnerships with Educational Institutions * Clube Certo * POP Pharma * Igreen * SESC Agreement * Life Insurance * Wellhub * Dental Plan * Health Plan * Meal/Voucher Allowance * Mobility Assistance * Commuter Pass * Telemedicine