Claims Associate Consumer

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

• Supports the organization's quality program(s).

Qualifications

• Education & Licensing: High school diploma or GED required. Licenses as required or willingness/ability to move toward obtaining appropriate licensing as required.
• Experience: One (1) year of general office experience or equivalent combination of education and experience required. Claims industry experience preferred.

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

• 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.