A globally focused organization delivering fair, efficient and transparent claims and dispute-resolution services is seeking an experienced Senior Claims Resolution Specialist to lead the assessment, investigation, negotiation, escalation and resolution of complex and disputed insurance claims.
About the Role — Complex Claims Resolution
Core Function: Managing complex, high-value, disputed and escalated claims from review through resolution
Investigation: Reviewing documentation, policy coverage, evidence and previous claim decisions
Negotiation: Negotiating settlements within delegated authority and established guidelines
Compliance: Ensuring claims decisions align with regulations, policy wording and delegated authorities
About This Claims Organization
Mission: Delivering fair, efficient, transparent and customer-centered claims services across diverse markets
Cross-Functional Teams: Claims, Underwriting, Legal, Compliance, Customer Experience and Fraud
Global Reach: Resolving complex claims and strengthening decision quality worldwide
Work Style: Fully remote role open to experienced professionals based in the UAE
Position Overview
This Senior Claims Resolution Specialist role involves managing complex, disputed and escalated claims from initial review through resolution, investigating disputes and assessing liability, indemnity and policy conditions, coordinating with adjusters, surveyors, medical professionals and legal advisers, negotiating settlements within delegated authority, identifying fraud indicators and regulatory escalation needs, conducting root-cause analysis of recurring disputes, maintaining accurate claims records, and providing technical guidance and coaching to claims specialists.
Why This Role Matters: As Senior Claims Resolution Specialist, you resolve the most complex, high-stakes claims that require careful judgment, negotiation skill and regulatory awareness, apply deep investigative expertise to uncover the real causes of disputes and delays, negotiate fair settlements that balance customer outcomes with commercial considerations, protect the organization through rigorous documentation and regulatory compliance, and shape claims-resolution strategy through coaching, process improvement and data-driven insight within a fully remote role open to UAE-based professionals.
Key Responsibilities
Claims Assessment & Investigation
- Manage complex, high-value, disputed and escalated claims from initial review through final resolution
- Review claim documentation, policy coverage, evidence and previous decisions
- Assess liability, indemnity, damages, exclusions, deductibles and policy conditions
- Coordinate with adjusters, surveyors, medical professionals, legal advisers and investigators
Negotiation & Resolution
- Develop resolution strategies for claims involving coverage, valuation or settlement disagreements
- Negotiate settlements within delegated authority and established guidelines
- Prepare claims-resolution recommendations for management approval
Compliance, Fraud & Escalation
- Identify cases requiring legal, compliance, fraud or senior management escalation
- Work with Legal and Compliance teams on litigation, regulatory complaints and customer-treatment standards
- Identify potential fraud indicators and refer suspicious claims to investigation teams
Quality, Reporting & Coaching
- Conduct root-cause analysis of recurring disputes and processing errors
- Support quality-assurance reviews and claims file audits
- Develop reports and dashboards on claims volumes, resolution times and outcomes
- Provide technical guidance, coaching and training to claims specialists
Qualifications & Requirements
Experience Requirements
- Strong experience in insurance claims, complex claims management or dispute resolution
- Proven experience managing complex, disputed, escalated or high-value insurance claims
- Preferably within a regulated insurance, reinsurance, brokerage or financial-services environment
Essential Skills
- Strong knowledge of insurance claims processes, policy interpretation and resolution practices
- Strong understanding of claims investigation, liability assessment, indemnity evaluation and settlement processes
- Excellent analytical and evidence-assessment capabilities
- Strong negotiation, mediation and conflict-resolution skills
About This Claims Resolution Opportunity
This Senior Claims Resolution Specialist role sits within a globally focused organization delivering fair, transparent claims and dispute-resolution services across diverse markets. Open to experienced professionals working remotely, including those based in the UAE, the position offers the chance to lead resolution of the most complex and sensitive insurance claims from investigation through settlement.
Career Excellence: Lead complex insurance claims resolution for a global claims organization, fully remote.
Who Should Apply?
- Senior Claims Handlers/Adjusters: With experience managing complex, high-value claims
- Dispute Resolution Specialists: Skilled in negotiation, mediation and conflict resolution
- Insurance Compliance Professionals: Familiar with regulatory requirements and customer-treatment standards
- Fraud-Aware Claims Investigators: Comfortable identifying and referring suspicious claims
- Remote-First Insurance Professionals: Based in the UAE and seeking senior claims resolution roles
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