Claims, Consultant
Core
End-to-end management of High Net Worth (HNW) claims, complaint resolution, and fraud risk mitigation for a health insurer.
Role type
Senior Claims Consultant (High Net Worth)
Builds
Reliable customer outcomes and compliant claim adjudication processes
Domain
Insurance / Health / High Net Worth
Required skills
HNW claims adjudication, complaint management, fraud detection, regulatory compliance (FATCA, CRS, AML), product design support, stakeholder collaboration
Preferred skills
FLMI, ALHC, complex case handling, root cause analysis
Technologies
IFPCD, internal claims guidelines, policy terms
Responsibilities
Manage end-to-end processing of HNW claims ensuring accurate adjudication; Resolve customer complaints and handle escalated cases; Coordinate fraud alerts and investigations; Provide technical input during product design and policy review; Support business transformation initiatives and process improvements.
Seniority
Senior, hands-on IC