Claims Analyst

Description

Job Summary: Responsible for analyzing, regulating, and monitoring claims, ensuring compliance with applicable regulations and legislation, with emphasis on service quality and risk mitigation. Key Highlights: 1. Analyze loss notices, verifying coverage and documentation 2. Monitor inspections, technical reports, and expert opinions 3. Identify fraud indicators and refer them to responsible departments Claims Analyst Analyze, regulate, and monitor claims, ensuring compliance with contractual terms, internal policies, and applicable legislation, with emphasis on service quality, risk mitigation, and cost control. Main Responsibilities * Analyze loss notices, verifying coverage, documentation, and contractual alignment; * Request, verify, and validate supplementary documents and information; * Monitor inspections, technical reports, expert appraisals, and specialized opinions; * Prepare technical reports and conclusive opinions; * Advise policyholders, brokers, and service providers; * Monitor deadlines and ensure adherence to established SLAs; * Identify fraud indicators and refer them to responsible departments; * Record and maintain up-to-date information in internal systems; * Knowledge of insurance policies, coverages, contractual clauses, and claims processes; * Prior experience in the claims area; * Intermediate Microsoft Office proficiency; * Knowledge of claims management systems (preferred). Preferred Qualifications * Certifications in the insurance field; * Experience in fraud prevention and analysis; * Familiarity with SUSEP regulations. Minimum Education: High School Diploma (Secondary Education) * Gympess * Meal Allowance – BRL 35.00 per day (iFood card) * Health Insurance – employee pays 30% (after probation period) * Dental Insurance – no cost to employee (after probation period) * Birthday Day Off