Senior Insurance Claims Specialist

Job Title: Senior Insurance Claims Specialist

Location: United Arab Emirates (Remote)

Employment Type: Full-Time

Work Arrangement: 100% Remote — Work From Home

Level: Senior

About the Role

We are seeking an experienced Senior Insurance Claims Specialist to manage and coordinate insurance claims assessment, documentation review, case monitoring, and claims process improvement. The role focuses on reviewing policy coverage, validating supporting evidence, analyzing claim circumstances, coordinating with policyholders and service providers, and ensuring that claims are processed accurately and efficiently. Working remotely, the specialist will collaborate with underwriting, legal, finance, customer service, medical or technical assessors, and authorized claims decision-makers to support fair, consistent, and compliant claims administration.

Key Responsibilities

• Review incoming insurance claims and verify that required forms, supporting documents, and evidence have been submitted.
• Assess claim documentation against applicable policy wording, coverage conditions, exclusions, deductibles, limits, and endorsements.
• Analyze claim circumstances, incident reports, invoices, medical records, repair estimates, and other relevant supporting information.
• Identify missing, inconsistent, incomplete, or potentially fraudulent information and coordinate further clarification.
• Prepare claim summaries, assessment reports, financial calculations, and recommendations for authorized claims decision-makers.
• Monitor claims throughout the processing lifecycle, ensuring that outstanding requirements and service deadlines are tracked.
• Coordinate with policyholders, brokers, insurers, repair providers, healthcare providers, loss adjusters, and other relevant stakeholders.
• Review loss adjustment reports, technical assessments, medical documentation, and independent expert findings for completeness and consistency.
• Support the assessment of claim reserves and potential financial exposure in accordance with established procedures.
• Identify complex, high-value, disputed, or unusual claims and escalate them to the appropriate specialists or management teams.
• Maintain accurate electronic claim files, correspondence records, supporting evidence, and decision documentation.
• Monitor claims handling performance, turnaround times, pending cases, and recurring operational issues.
• Support investigations into suspected fraud, misrepresentation, duplicate claims, and unusual claims patterns.
• Coordinate with legal and compliance teams on disputed claims, complaints, litigation-related documentation, and regulatory information requests.
• Assist with claims reconciliation and coordination between claims administration, finance, and payment processing teams.
• Review claims handling procedures and recommend improvements to documentation standards, workflow efficiency, and quality controls.
• Support internal audits, claims quality reviews, and compliance assessments.
• Prepare management reports covering claims volumes, settlement trends, outstanding liabilities, processing performance, and exception rates.
• Provide guidance to junior claims personnel on policy interpretation, documentation review, and case management standards.
• Maintain awareness of relevant insurance regulations, claims practices, and changes in policy administration requirements.

Qualifications and Experience

• Bachelor's degree in Insurance, Finance, Business Administration, Accounting, Risk Management, or a related discipline.
• Significant experience in insurance claims administration, claims assessment, insurance operations, or loss management.
• Strong understanding of insurance policy structures, coverage conditions, exclusions, deductibles, limits, and claims procedures.
• Experience reviewing and validating claims documentation across relevant insurance lines, such as property, motor, medical, life, or general insurance.
• Knowledge of claims investigation processes, loss assessment documentation, and fraud indicators.
• Familiarity with claims management platforms, policy administration systems, document management tools, and reporting applications.
• Understanding of insurance reserving principles, claims financial calculations, and settlement workflows.
• Knowledge of applicable UAE insurance regulatory requirements and relevant compliance standards.
• Ability to analyze complex claim information and identify discrepancies, coverage concerns, and potential risk exposure.
• Strong written communication and report preparation skills.
• Excellent stakeholder management, negotiation support, and problem-solving capabilities.
• High standards of confidentiality, integrity, accuracy, and attention to detail.
• Ability to manage sensitive cases and multiple deadlines independently in a fully remote environment.
• Professional certifications such as ACII, CII, or other recognized insurance qualifications are an advantage.

What We Offer

• A fully remote, work-from-home position based in the UAE.
• The opportunity to contribute to efficient and reliable insurance claims operations.
• Exposure to diverse insurance products, claims assessment processes, and risk management activities.
• Collaboration with insurance, underwriting, finance, legal, and customer service professionals.
• Opportunities for professional development in insurance claims and risk management.

How to Apply

Interested candidates should submit an updated CV highlighting their insurance claims experience, policy knowledge, assessment capabilities, and relevant professional qualifications.

Application Subject: Application – Senior Insurance Claims Specialist (UAE Remote)

Candidates should confirm applicable employment arrangements, UAE residency requirements, and work authorization before accepting an offer.

• Role Scope: This is a remote claims documentation review, analysis, coordination, and operational support position. Physical inspections, medical examinations, vehicle assessments, property surveys, and other on-site evidence collection must be performed by qualified local professionals. Final coverage determinations, claim repudiations, settlement approvals, regulated insurance decisions, and formal legal or regulatory representations must be made or authorized by appropriately designated personnel in accordance with applicable laws and company policies.