Claims Associate - Consumer

Description :

PRIMARY PURPOSE : To process claims and determine benefits due pursuant to credit card or other financial program benefits plans;

to make timely payments and adjustments for specified program claims; and to provide superior customer service.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

Processes first party property claims based on basic coverage as defined by client-specific program.

Makes coverage determinations based on investigation / evaluation.

Adjudicates proper settlement or denials up to designated authority level.

Handles high volume of claims, phone calls and correspondence ensuring claim files are properly documented; meets quality and production goals;

and meets customer guidelines and deadlines.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

Performs other duties as assigned.

Supports the organization's quality program(s).

Requirements :

PRESCREEN QUESTIONS REQUIRED AT THE TOP OF RESUME

Do you have experience in claims adjudication?

In your most recent claims experience, how many claims have you had in your inventory? (looking understand how much volume they are used to...preferably above claims)

Have you managed a claim inventory before?

Have you had a daily productivity goal you had to achieve? If so, what was that and please explain if you hit that goal or exceeded?

What other metrics did you have in a claim’s role? Looking for if they talk about productivity, quality / accuracy of claims handling, phone skills?

What experience do you have working from home?

How comfortable are you using the elements of Microsoft office and using multiple systems at once? If yes, can you give an example from your experience?

What do you like / dislike about your current work environment?

What company is your current internet Provider? Telecommunication G home internet is not compatible with our equipment.

THERE IS A FIRM START DATE OF / FOR TRAINING

Training Schedule Info

Training will take place - / / and last for approximately weeks.

Training Time - Monday - Friday : am EST : PM EST ( hour lunch break)

BGC needs to be cleared before st week of Nov.

WORK SCHEDULE :

After training the contractor can pick the schedule below. we have some flexibility with them having a start time between : am EST- : am EST but would prefer the schedules below.

The time is fixed once they decide.

Monday through Friday : am : PM ( hour lunch break)

Monday through Friday : am : PM (-minute lunch break)

Equipment will be provided (desktop, monitors, keyboard, mouse, phone / headset) but they may need to use a personal device to attend at the start of training.

This will depend on arrival of equipment. They are required to be on camera during our remote training classes. It is their responsibility to have a home internet provider.

We will need to confirm the Company of their internet supplier as well since Telecommunication G home internet is not compatible with our equipment.

Criminal screens must be completed prior to starting.

QUALIFICATIONS

Education & Licensing High school diploma or GED required. They do not need to be licensed.

One () year of general office experience or equivalent combination of education and experience required. Claims industry experience preferred.

Candidates need to be quick decision makers and be able to work in fast paced environment.

Skills & Knowledge

Knowledge of first party property and casualty claim adjudication as applicable to line of business

Good oral and written communication, including presentation skills

PC literate, including Microsoft Office products

Analytical and interpretive skills

Good organizational skills

Good interpersonal skills

Ability to work in a team environment

Ability to meet or exceed Performance Competencies

WORK ENVIRONMENT - When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental : Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion;

ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

Physical : Computer keyboarding, travel as required

Auditory / Visual : Hearing, vision and talking

EEO :