Claim Operations Specialist

About the Role

Under moderate supervision, this position is responsible for partnering with claim professionals to assist customers. Responsibilities 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 others.

Responsibilities

• Customer Engagement: Serves as a customer service representative for the claim department by promptly and professionally addressing customer questions and concerns, which may include:
  • Triage and route callers to the appropriate department.
  • Answer 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 document claim files, including notes and diaries.
  • Request reports and records, and review medical bills, mail, and wage statements.
  • Print and prepare claim documents for legal and medical reviews.
  • Report and assign claims, and transition closed files to and from off-site storage.
  • Receive, sort, scan, and upload incoming mail, and process outgoing mail.
  • Order, receive, and distribute supplies and/or equipment.
• Claim Payments and Expense Processing: Ensures the proper handling of financial transactions to include:
  • Process and issue claim payments including outside vendor invoices, attorney expenses, and medical processing fees.
  • Process and document returned checks, voided checks, and credits.
  • Ensure timeliness and accuracy of all check processing.
• Data and Information Management: Maintain accurate records and information management, such as:
  • Prepare, generate, and review reports using the most effective technology.
  • Update data discrepancies identified in reports and systems.
  • Use management information data to prepare line of business or financial reports.
  • Prepare operational reports for claim professionals and managers.
  • Accurately document pending and completed work activities using appropriate systems.
• Financial Controls and Assessments: Assist with claim center financial standards, including:
  • Perform underlying controls and effectively communicate findings.
  • Assess the reasonableness of data as well as identify discrepancies, including reconciliations.
  • Assess the effectiveness of financial controls.
  • Prepare data entries in accordance with established standards.
• May require lifting items up to 20 pounds (occasionally).
• Perform other duties as assigned.

Requirements

• High School Diploma or GED.
• 1 year of service-related work experience OR Bachelor’s Degree.

Skills

• Experience utilizing computer technology such as Microsoft Office, e-mail, Web-enabled applications, and database software.
• Accountability: Takes ownership and responsibility for actions and outcomes, performance, and results.
• Analytical Thinking: Ability to analyze and compare information to understand issues and explore alternative solutions.
• Change Management/Resilience: Ability to remain energized and focused in the face of ambiguity, change, or strenuous demands.
• Communication Skills: Verbal and written communication skills.
• Judgment/Decision Making: Ability to exercise sound judgment and make decisions.
• Relationship Management: Ability to seek out, build, foster, and maintain productive working relationships to meet goals and achieve results.

Pay

The annual base salary range for this position is $45,400.00 - $74,900.00. The actual salary will be determined by factors including the scope, complexity, and location of the role; skills, education, training, credentials, and experience of the candidate; and other conditions of employment. Employees are also eligible for performance-based cash incentive awards.

Benefits

• Health Insurance: Employees and their eligible family members – including spouses, domestic partners, and children – are eligible for coverage from the first day of employment.
• Retirement:
  • Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum.
  • If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account.
  • Eligible for a Pension Plan that is 100% funded by Travelers.
• Paid Time Off: Start with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.
• Wellness Program: Comprised of tools, discounts, and resources that empower you to achieve your wellness goals and caregiving needs. Includes access to free professional counseling services, health coaching, and other resources to support daily life needs.
• Volunteer Encouragement: Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice.