The primary function of this role is to support the PCM Claims Intake process by accurately setting up claims, reviewing intake documentation, routing claims to the appropriate adjusters, and maintaining service quality standards.
Claim Setup and Intake Processing
- Perform claim setup activities for Property (Pet) and Casualty claims as per SOP.
- Review claim submission documents, emails, and supporting information.
- Run loss reports as required by SOP.
Assignment and Routing Responsibilities
- Assign claims to onshore claim adjusters as per SOP.
- Ensure timely claim routing and workflow management.
Communication Responsibilities
- Send acknowledgment (ACK) letters to onshore teams for review.
- Maintain professional communication with stakeholders.
Systems and Documentation Requirements
- Utilize W5 and related claims systems.
- Review policy documents using Foxit Reader.
Escalation Procedures
- Team Lead/Manager Pune Team
- AVP Operations Pune Team
- VP Operations Pune Team
Reporting and Quality Expectations
- Maintain 95% quality accuracy.
- Meet weekly production targets.
- Weekly production and accuracy reports shared by Team Lead/Manager.
Cross-Training and Backup Responsibilities
- Actively participates in cross-training and provides backup support across BAU processes, ensuring business continuity, operational flexibility, and consistent service delivery during team absences or peak workload periods.
- Professional, positive, and customer-focused attitude.
- Strong written and verbal communication skills.
- Attention to detail and ability to follow SOPs.
- Ability to manage multiple priorities and meet production targets.
- Prior insurance claims experience preferred.