Senior Claims Subject Matter Expert - Property & Casualty Insurance

Claims SME – Property & Casualty (P&C) Insurance

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.