Claim Operations Specialist

Role Overview

• 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; Answers claim status and payment questions.\n
• CLAIM OPERATIONAL SERVICE AND PARTNERSHIPS: Partners with claim professionals in multiple departments to assist with the timely resolution of claims, which may include: Properly documents claim files, including notes and diaries, Requests reports and records, and reviews medical bills, mail and wage statements. Prints and prepares claim documents for legal and medical reviews. Reports and assigns claims, and transitions closed files to and from off-site storage. Receives, sorts, scans, and uploads incoming mail, and processes out-going mail. Orders, receives and distributes supplies and/or equipment.\n
• CLAIM PAYMENTS AND EXPENSE PROCESSING: Ensures the proper handling of financial transactions to include: Processes and issues claim payments including outside vendor invoices, attorney expenses, and medical processing fees. Processes and documents returned checks, voided checks and credits. Ensures timeliness and accuracy of all check processing.\n
• DATA AND INFORMATION MANAGEMENT: Maintains accurate records and information management, such as: Prepares, generates and reviews reports using the most effective technology. Updates data discrepancies identified in reports and systems. Uses management information data to prepare line of business or financial reports. Prepares operational reports for claim professionals and managers. Accurately documents pending and completed work activities using appropriate systems.\n
• FINANCIAL CONTROLS AND ASSESSMENTS: Assists with claim center financial standards, including: Performs underlying controls and effectively communicates findings. Assesses the reasonableness of data as well as identifying discrepancies, including reconciliations. Assesses the effectiveness of financial controls. Prepares 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.\n
• 1 year of service-related work experience OR Bachelor’s Degree.\n
• Experience utilizing computer technology such as Microsoft Office, e-mail, Web-enabled applications, and database software.\n
• Accountability: Takes ownership and responsibility for actions and outcomes, performance and results.\n
• Analytical Thinking: Ability to analyze and compare information to understand issues and explore alternative solutions.\n
• Change Management/Resilience: Ability to remain energized and focused in the face of ambiguity, change or strenuous demands.\n
• Communication Skills: Verbal and written communication skills.\n
• Judgment/Decision Making: Ability to exercise sound judgment and make decisions.\n
• Relationship Management: Ability to seek out, build, foster and maintain productive working relationships to meet goals and achieve results.

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.\n
• 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. You are also eligible for a Pension Plan that is 100% funded by Travelers.\n
• Paid Time Off: Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.\n
• Wellness Program: The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs.\n
• Volunteer Encouragement: We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice.