Description

JOB DESCRIPTION

Claims Adjuster - T his is position with the North America Accident & Health Claims Department.

The North America Accident and Health Claims Department is seeking a Claim Adjuster to join our fast-paced, high energy, growing Company. We are proud of our tradition of success in the insurance industry of nearly 100 years. Come join our team of hard-working, talented professionals!

The Claims Adjuster is responsible for contacting claimants and /or service providers to request information needed to process claims - includes written correspondence and phone calls. They will evaluate claims based on documentation received, including responses from claimants and providers.

Will need to handle multiple priorities simultaneously, be self-directed and meet service level expectations.

The Claims Adjuster must demonstrate customer centricity in all aspects of their job by performing actions with empathy and expertise.

RESPONSIBILITIES:

• Efficiently and accurately adjudicate claims in accordance with the policy terms, established guidelines, and regulations.
• Conduct eligibility claim reviews by evaluating claim submissions and comparing to policy benefits.
• Request additional information from policyholders, providers, and others as necessary to finalize claims.
• Actively manage inventory and ongoing claim adjudication.
• Effectively communicate with customers using empathy and professionalism via phone and written correspondence.
• Interface with Policyholders and Agents answering a variety of questions through different service channels.
• Develop a broad understanding of our products and systems.
• Meet Department standards for time, service, and quality.
• Ability to confidently maneuver between system applications to find information and respond to customer needs in a timely manner.
• Collaborate with other team members and leadership to ensure effective customer service.
• Actively engage in continuous Improvement initiatives and identify process and efficiency enhancements.
• Participate in required training.
• Perform other duties as assigned.

Requisition #: 25874

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