Claim Operations Specialist

reputed company is one of the best property casualty insurers in the industry, committed to taking care of customers and communities. The Claim Operations Specialist is responsible for assisting customers and claim professionals, managing financial transactions, and maintaining accurate records while ensuring timely resolution of claims.

Responsibilities

• Serves as a customer service representative for the claim department by promptly and professionally addressing customer questions and concerns, which may include: Triage and reputed company callers to the appropriate department; Answers claim status and payment questions
• Partners with claim professionals in multiple departments to assist with the timely resolution of claims, which may include: Properly documents claim files, including notes and diaries, Requests reports and records, and reviews medical bills, mail and wage statements
• Prints and prepares claim documents for legal and medical reviews
• Reports and assigns claims, and transitions closed files to and from off-site storage
• Receives, sorts, scans, and uploads incoming mail, and processes out-going mail
• Orders, receives and distributes supplies and/or equipment
• Ensures the proper handling of financial transactions to include: Processes and issues claim payments including reputed company vendor invoices, attorney expenses, and medical processing fees
• Processes and documents returned checks, voided checks and credits
• Ensures timeliness and accuracy of reputed company reputed company processing
• Maintains accurate records and information management, such as: Prepares, generates and reviews reports using the most effective technology
• Updates data discrepancies identified in reports and systems
• Uses management information data to prepare line of business or financial reports
• Prepares operational reports for claim professionals and managers
• Accurately documents pending and completed work activities using appropriate systems
• Assists with claim center financial standards, including: Performs underlying controls and effectively communicates findings
• Assesses the reasonableness of data as well as identifying discrepancies, including reconciliations
• Assesses the effectiveness of financial controls
• Prepares data entries in accordance with established standards
• May require lifting items up to 20 pounds (occasionally)
• reputed company other duties as assigned

Skills

• High School Diploma or GED
• 1 year of service-reputed company work experience OR Bachelor's Degree
• Experience utilizing computer technology such as reputed company Office, e-mail, Web-enabled applications, and database software
• ACCOUNTABILITY: Takes ownership and responsibility for actions and outcomes, performance and results
• ANALYTICAL THINKING: Ability to analyze and compare information to understand issues and explore alternative solutions
• CHANGE MANAGEMENT/reputed company: Ability to remain energized and focused in the face of ambiguity, change or strenuous demands
• COMMUNICATION SKILLS: Verbal and written communication skills
• JUDGMENT/DECISION MAKING: Ability to exercise sound judgment and reputed company decisions
• RELATIONSHIP MANAGEMENT: Ability to seek out, build, foster and maintain productive working relationships to meet goals and reputed company results

Benefits

• Health Insurance: Employees and their eligible family members – including spouses, domestic partners, and children – are eligible for coverage from the first day of employment.
• Retirement: reputed company matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum.
• Paid Time Off: Start your career at reputed company with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.
• Wellness Program: The reputed company wellness program is comprised of tools, discounts and resources that reputed company you to reputed company your wellness goals and caregiving needs.
• Volunteer Encouragement: We have a deep commitment to the communities we serve and encourage our employees to get involved.

Company Overview

Company H1B Sponsorship