Job Title:Claims Examiner Assistant - Flood BPO - Travelers
Job Category:Third Party Administration
Description
Essential Job Functions
Job Category:Third Party Administration
Description
Essential Job Functions
- Enters insurance claims received electronically or in written form.
- Answers incoming customer calls regarding claim processing. Documents claim and associated history.
- Evaluates available information to validate straightforward basic claims. Verifies policyholder information, policy effective dates, premium status, and verification of claim eligibility.
- Sends claim form to claimant.
- Identifies need for additional information; contacts appropriate source to obtain needed information. Verifies beneficiary or claimant information if claim is warranted. Identifies payment amount and obtains required management approvals for payment. Processes payment.
- Advises claimant of status and resolution of claim. Escalates claimant concerns as appropriate.
- Completes special projects or performs other duties as necessary.
Qualification
Basic Qualifications
- High school diploma or G.E.D.
- Zero or more years of claims experience
- Experience working with insurance and/or medical terminology
- Experience working with appropriate claims processing procedures and documentation
Other Qualifications
- Basic analytical and problem solving skills
- Interpersonal skills to interact with team members
- Communication skills to communicate with customers
- Data entry skills
- Ability to keep sensitive and confidential material private
- Ability to work in a team environment
