AlpharettaRecruiter Since 2001
the smart solution for Alpharetta jobs

Claim Operations Specialist

Company: Travelers
Location: Alpharetta
Posted on: January 16, 2020

Job Description:

Company Information

Solid reputation, passionate people and endless opportunities. That's Travelers. Our superior financial strength and consistent record of strong operating returns mean security for our customers - and opportunities for our employees. You will find Travelers to be full of energy and a workplace in which you truly can make a difference.

Job Summary


  • Under moderate supervision, this position is responsible for partnering with claim professionals to assist customers.
  • Responsibilities within the team include building customer relationships, completing financial transactions, updating and managing important business information, and handling numerous other duties and projects.
  • This position does not manage staff.
  • As part of the hiring process, this position requires the completion of an online pre-employment assessment.
  • Further information regarding the assessment including an accommodation process, if needed, will be provided at such time as your candidacy is deemed appropriate for further consideration.


    Primary Job Duties & Responsibilities


    • Customer Engagement: Serves as a customer service representative for the claim department by promptly and professionally addressing external and internal customer questions and concerns, which may include: Triage and route callers to the appropriate department. Answers claim status and payment questions.
    • Claim Operational Service and Partnerships: 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.
    • Corrects wage statements.
    • Requests police reports and medical records.
    • Reviews medical bills for proper billing and coding.
    • Prints and prepares claim documents for legal and medical reviews.
    • Reports claims to other insurance companies.
    • Assigns new claims to the appropriate claim professional.
    • Transitions closed files to and from off-site storage using records management systems.
    • Receives, sorts, scans, and uploads incoming mail.
    • Researches for the appropriate recipient.
    • Processes out-going mail, including overnight packages as needed.
    • Orders, receives and distributes supplies and/or equipment.
    • Claim Payments and Expense Processing: Ensures the proper handling of financial transactions to include: Processes and issues claim payments including outside vendor invoices, attorney expenses, and medical processing fees. Processes and documents returned checks, voided checks and credits. Ensures timeliness and accuracy of all check processing.
    • Data and Information Management: Maintains accurate records and information management, such as: Prepares, generates and reviews daily/monthly/quarterly and ad hoc 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.
    • Financial Controls and Assessments: 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.
    • Supports statutory reporting requirements.
    • Other duties as assigned.


      Minimum Qualifications

      High School Diploma or GED with one year of work or customer service related experience OR Bachelor's Degree required.

      Job Specific & Technical Skills & Competencies


      • Accountability: Takes ownership and responsibility for actions and outcomes, performance and results.
      • Analytical Thinking: Identifies current or future problems or opportunities, analyzes, synthesize and compares information to understand issues, identifies cause/effect relationships and explores alternative solutions to support sound decision-making.
      • Change Management / Resilience: Remains energized and focused in the face of ambiguity, change or strenuous demands.
      • Communication Skills: Good verbal and written and listening communication skills including telephone protocols.
      • Customer Focus: Provides service excellence to internal or external clients.
      • Judgment / Decision Making: Exercises sound judgment makes decisions and commits to a position.
      • Relationship Management: Seeks out, builds, fosters and maintains productive relationships, networks or alliances to meet goals and achieve results.
      • Teamwork: Works together in situations when actions are interdependent and a team is mutually responsible to produce a result.
      • Time Management: Ability to prioritize, highly organized, able to multi-task in order to meet deadlines.


        Environmental/Work Schedules/Other

        Other: Travel - Occasionally Occasional overtime based on business need.

        Preferred Qualifications

        bi-lingual candidates encouraged to apply

        Physical Requirements

        Operates standard office equipment - continuously Sitting (can stand at will) - continuously Standing (can sit at will) - continuously Lifting items up to 25 pounds - frequently Use of Keyboards, Sporadic 10-Key - continuously Working in a confined or restricted area - occasionally Driving - occasionally for training or business travel Other: Pushing and pulling of mail carts, up to 25 pounds, several times per day.

        Equal Employment Opportunity Statement

        Travelers is an equal opportunity employer.

Keywords: Travelers, Alpharetta , Claim Operations Specialist, Other , Alpharetta, Georgia

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Other Jobs


Hair Stylist - Sugar Hill Corner
Description: StylistAt Great Clips, we know that stylists like you are most happy when they're cutting hair, so at a Great Clips salon, that's exactly what you get to do Want to be the best stylist
Company: Great Clips, Inc.
Location: Alpharetta
Posted on: 01/24/2020

Supervisor Contact Center
Description: AT DELTA DENTAL WE: br PROMOTE ACCOUNTABILITY, INTEGRITY AND COLLABORATION: Our employees are collaborative, self-aware, and ethical. It is our expectation to do the right thing and follow through on (more...)
Company: Delta Dental of California
Location: Alpharetta
Posted on: 01/24/2020

Hair Stylist - Ocoee Crossing
Description: StylistAt Great Clips, we know that stylists like you are most happy when they're cutting hair, so at a Great Clips salon, that's exactly what you get to do Want to be the best stylist
Company: Great Clips, Inc.
Location: Cleveland
Posted on: 01/24/2020


CDL-A Experienced Flatbed Truck Driver
Description: Average .61 CPM with Boyd Bros. The best flatbed truck driver jobs are right here at Boyd. Bros- the company the best drivers call home. And now,
Company: Boyd Brothers Transportation
Location: Cleveland
Posted on: 01/24/2020

Established Team Drivers
Description: Hiring Established Team Drivers 5,000 Sign-on Bonus Seeking Established Team Drivers with 1 Year Experience Established Team Driver Benefits: Teams can earn up to .62 CPM 5,000 Sign-On
Company: Storey Trucking Co Inc
Location: Cleveland
Posted on: 01/24/2020

Team Driver
Description: Hiring Established Team Drivers 5,000 Sign-on Bonus Seeking Established Team Drivers with 1 Year Experience Established Team Driver Benefits: Teams can earn up to .62 CPM 5,000 Sign-On
Company: Storey Trucking Co Inc
Location: Cleveland
Posted on: 01/24/2020

CDL-A Truck Driver, New Regional Pay Scale
Description: 100 Committed to a Positive Driver Experience CDL-A South Regional Truck Drivers Earn Up To .50 CPM At USA Truck, we are 100 committed to a positive driver experience. That's why we focus on how (more...)
Company: USA Truck
Location: Cleveland
Posted on: 01/24/2020

Home Based Opportunity
Description: A strong company that has been in business since 1992. We are leading the way in Consumer Driven Health Care WHO WE ARE AND
Company: Healthcare Benefits
Location: Alpharetta
Posted on: 01/24/2020

Esthetician
Description: Brand new salon opening in Grayson Village, Grayson Ga. We are hiring licensed estheticians, who
Company: Defavorisee Salon Suites
Location: Alpharetta
Posted on: 01/24/2020

KFC Team Member
Description: Description br br This job posting is for a position in a restaurant that is independently owned and operated by a franchisee. This means your application will be reviewed by the franchisee who will (more...)
Company: KFC
Location: Alpharetta
Posted on: 01/24/2020

Log In or Create An Account

Get the latest Georgia jobs by following @recnetGA on Twitter!

Alpharetta RSS job feeds