Claim Representative-TPA Oversight - OneTenCoalition
Los Angeles, CA
About the Job
JOB DESCRIPTION
Chubb - Claims Representative - TPA Oversight
The TPA Oversight Claims Representative will work within the TPA Oversight Department and cross-functionally with internal business partners to execute operations tasks, including assigning and transferring claims, identifying TPA companies, and routing electronic correspondence. The Claims Representative assists claims handlers and management with day-to-day functions, including but not limited to Medicare data queries, claim closings, and payment issuance. The Claims Representative will be responsible for special assignments that increase departmental efficiency and is expected to support continuous improvement initiatives. The Claims Representative will deliver a superior level of claims processing functions and customer service under limited supervision.
MAJOR DUTIES/RESPONSIBILITIES OF THE JOB:
QUALIFICATIONS
ABOUT US
Chubb is a world leader in insurance. With operations in 54 countries, Chubb provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance, and life insurance to a diverse group of clients. The company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally.
At Chubb, we are committed to equal employment opportunity and compliance with all laws and regulations pertaining to it. Our policy is to provide employment, training, compensation, promotion, and other conditions or opportunities of employment, without regard to race, color, religious creed, sex, gender, gender identity, gender expression, sexual orientation, marital status, national origin, ancestry, mental and physical disability, medical condition, genetic information, military and veteran status, age, and pregnancy or any other characteristic protected by law. Performance and qualifications are the only basis upon which we hire, assign, promote, compensate, develop and retain employees. Chubb prohibits all unlawful discrimination, harassment and retaliation against any individual who reports discrimination or harassment.
Chubb - Claims Representative - TPA Oversight
The TPA Oversight Claims Representative will work within the TPA Oversight Department and cross-functionally with internal business partners to execute operations tasks, including assigning and transferring claims, identifying TPA companies, and routing electronic correspondence. The Claims Representative assists claims handlers and management with day-to-day functions, including but not limited to Medicare data queries, claim closings, and payment issuance. The Claims Representative will be responsible for special assignments that increase departmental efficiency and is expected to support continuous improvement initiatives. The Claims Representative will deliver a superior level of claims processing functions and customer service under limited supervision.
MAJOR DUTIES/RESPONSIBILITIES OF THE JOB:
- Review and research new claims to assist with loss assignments, including initial assignments to handlers and redirection of losses to TPA companies.
- Analyze incoming electronic correspondence and route it to the correct handler and claim file.
- Support TPA Oversight management.
- Assist adjusters with claims handling responsibilities, including drafting of coverage letters, Medicare data queries, and closure of claims.
- Contribute to the TPA Oversight department's efficiency by completing special projects, such as a review of shadow files to ensure resolved claims are closed.
- Ensure direct actions against Chubb are reviewed timely and referred to counsel to protect Chubb's interests.
- Partner with colleagues both within TPA Oversight and in other departments to continually improve quality and innovation.
- Support an environment of continuous improvement by offering ideas and suggestions to enhance the service level provided to customers and improve workflow issues.
- Promptly report service and/or system problems to the supervisor to ensure service levels to customers and business partners are not adversely impacted.
QUALIFICATIONS
- High School Diploma or GED Equivalent.
- Effective time management and organizational skills, with the ability to handle multiple tasks simultaneously.
- Strong quality customer service skills.
- Excellent verbal and written communication and interpersonal skills.
- Ability to work effectively in a team environment.
- Basic claim investigation skills.
- Ability to meet or exceed established performance standards.
- Ability to work autonomously, using sound judgment to review and assign claims.
- Thorough understanding and knowledge of claims systems.
ABOUT US
Chubb is a world leader in insurance. With operations in 54 countries, Chubb provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance, and life insurance to a diverse group of clients. The company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally.
At Chubb, we are committed to equal employment opportunity and compliance with all laws and regulations pertaining to it. Our policy is to provide employment, training, compensation, promotion, and other conditions or opportunities of employment, without regard to race, color, religious creed, sex, gender, gender identity, gender expression, sexual orientation, marital status, national origin, ancestry, mental and physical disability, medical condition, genetic information, military and veteran status, age, and pregnancy or any other characteristic protected by law. Performance and qualifications are the only basis upon which we hire, assign, promote, compensate, develop and retain employees. Chubb prohibits all unlawful discrimination, harassment and retaliation against any individual who reports discrimination or harassment.
Source : OneTenCoalition