This position will perform and deliver on routine assignments for his/her assigned area(s) of claims responsibility independently in accordance with established procedures/guidelines. S/he will process standard claims ensuring the fair, ethical and timely processing of assigned claims.
Applies core knowledge obtained for the role to effectively communicates verbally and in written form with internal/external stakeholders to obtain needed information while maintaining a professional demeanor in all interactions.
Ensures the accuracy and completeness of submitted claims.
Escalates claims issues or concerns to senior team members and/or management.
Processes assigned claims for payment or denial in accordance with established procedures and guidelines, in a timely manner and meeting departmental quality/production standards.
Provides superior customer service to internal and/or external stakeholders, recognizes what needs to be done to meet customer needs and demonstrates flexibility and responsiveness to meet customer needs.
Recognizes general issues/concerns for assigned area(s), explains effect on the customer's service experience, and suggests process improvements.
Reviews and provides specific information to questions/concerns from internal/external stakeholders (e. g. internal partners, policyholders, brokers, etc.) by applying core knowledge obtained for the role.
Reviews submitted claim information for payment.
Education & Experience
0 - 1+ Years of general experience - need not be directly related to position (Required)