Job Summary:

• Providing administrative support to HUB International clients on all claims-related matters including claims updates and reporting.
• Providing guidance to internal teams on the claims process and building knowledge and capability.
• Effectively analyze and interpret policy wording.
• Working closely with the Claims team
• Providing status updates to Client and Account Teams and providing appropriate consulting and guidance where required.
• Participating in team and client meetings
• Maintaining accurate and up-to-date electronic claims files through Epic.
• Managing logistic partners and engaging them to full fill claims within specific TAT
• Engaging with ARC (authorized repair centers) on quotations, RNF and invoices for devices that sent for repair
• Preparing ad hoc reporting via Microsoft PowerPoint

Skills on Resume: 

• Claims Management Knowledge (Hard Skills)
• Administrative Proficiency (Hard Skills)
• Communication Skills (Soft Skills)
• Analytical Skills (Hard Skills)
• Reporting and Presentation Skills (Hard Skills)
• Stakeholder Management (Soft Skills)
• Team Collaboration (Soft Skills)
• Attention to Detail (Soft Skills)

Job Summary:

• Conducts investigation into all accessible information (via Bird’s internal systems and outside research) to gather relevant facts to help resolve safety issues and determine appropriate courses of action in conjunction with stakeholders.
• Analyze safety incidents to determine appropriate action items (written acknowledgment, place outbound phone calls appeasement, submission as insurance claim).
• Maintaining excellent interpersonal skills and professionalism while delivering outstanding customer service.
• Employ critical thinking, emotional intelligence, and creative problem-solving skills to navigate sensitive cases and high severity safety concerns.
• Utilize internal databases to craft arguments and defenses for various claims.
• Draft standard written and verbal follow-up for unique events and safety-related issues
• Compile incident data for insurance claim submission.
• Coordinate claims processing with third-party administrator
• Assist the WTW WC and GL claims specialists, as necessary.
• Assist OCIP Loss Control Staff, Investigators, and Defense Counsel with registering for Safety Courses and securing necessary credentials.
• Review and analyze claim trends
• Monitor and track claim and legal billing.
• Provide monthly/quarterly reports to risk management team.
• Assist the risk management department with various other aspects of the management and supervision of the OCIP programs

Skills on Resume: 

• Investigative Skills (Hard Skills)
• Analytical Skills (Hard Skills)
• Interpersonal Skills (Soft Skills)
• Critical Thinking and Problem Solving (Soft Skills)
• Database Management (Hard Skills)
• Communication Skills (Soft Skills)
• Claims Coordination (Hard Skills)
• Data Analysis (Hard Skills)

Job Summary:

• Manage the BAH Claims mailbox
• Setup and data entry of all new claim submissions.
• Forwarding and filing all aggregate reports and notices to appropriate parties.
• Responding to claim status requests
• File set up and saving of claim submissions on internal hard drives.
• Monthly retrieval of FTP claims reports for review and logging into DYS.
• Respond to Claim Analyst requests and correction queries.
• Handle claims received from internal David Young Exchange Center.
• Handling of Managed Care claims
• Logging data on internal spreadsheet.
• Uploading & Downloading to a third party for processing & handling.
• Mailing completed reports and checks.
• Prescreen Initial claim submissions for specific missing information and communicate to claims administrator.

Skills on Resume: 

• Attention to Detail (Hard Skills)
• Organizational Skills (Hard Skills)
• Communication Skills (Soft Skills)
• Administrative Proficiency (Hard Skills)
• Technical Aptitude (Hard Skills)
• Problem-Solving Skills (Hard Skills)
• Customer Service Orientation (Soft Skills)
• Adaptability (Soft Skills)

Job Summary:

• Responds on a timely basis to Operations inquiries concerning Worker Compensation or other claims.
• Works closely with Operations on risk management techniques. 
• Develops strong relationship with Operations and actively contributes to mitigate risk at the store level. 
• Contributes to safety compliance, exposure savings, reduction of frequency and severity.
• Intake of First Notice of Loss via Internet
• Submit ISO claim search on Medical only and Indemnity claims
• Process incoming mail & faxes
• Clarify on billing & records
• Check disbursement and attend Client Seminars
• Approve/Review EDI payables
• Employer contact for documents
• Answer phones, scanning, check mail
• Review with managed care organization
• Assembling Claims Manuals for new members
• Scanned documents are attached to the claim file
• Enter Direct Payments in the system

Skills on Resume: 

• Claims Management (Hard Skills)
• Risk Management (Hard Skills)
• Safety Compliance (Hard Skills)
• First Notice of Loss (FNOL) (Hard Skills)
• Claims Processing (Hard Skills)
• Document Management (Hard Skills)
• Client Interaction (Soft Skills)
• Administrative Support (Soft Skills)

Job Summary:

• Handling Personal and Commercial Multi-Line Claims (i.e. Automobile, Property, Casualty, Professional Liability, Workers Compensation, Disability, and PFL) from beginning to End
• Assist clients in presenting claims to the carriers
• Address client concerns and act as advocate when dealing with the insurance carrier’s Claims Department
• Review and dispute carrier Denials, Disclaimers of Coverage, and Reservation of Rights Letters when necessary
• Furnish Account Managers with Claim Summaries and Large Claim Reviews as requested
• Provide back up to the Claims Manager
• Take/receive first notice from client
• Identify applicable coverage and set up claim in claim management system with a 24-hour turn around
• Large losses (i.e. Fire, Floods, Automobile Accidents and all other claims involving injuries), and Summons and Complaints must be processed immediately
• Workers Compensation and all rush claims must be called in to the carrier
• Submit claim to the carrier with all supporting documents
• Set up a follow-up suspense, follow up accordingly
• Submit status to pertinent parties
• Review files and Loss Runs periodically and as requested to ensure that claims are being properly reserved

Skills on Resume: 

• Claims Management (Hard Skills)
• Client Advocacy (Soft Skills)
• Coverage Analysis (Hard Skills)
• Documentation and Reporting (Hard Skills)
• Time Management (Soft Skills)
• Communication Skills (Soft Skills)
• System Proficiency (Hard Skills)
• Analytical Skills (Hard Skills)

Job Summary:

• Managing the end-to-end processing of claims for Garner's employer incentive program across entire customer base, which includes reviewing documentation
• Determining reimbursement eligibility and processing payments
• Reviewing relevant policies to confirm coverage details and limits
• Following up with members for additional details
• Supporting the Garner concierge team in answering incoming member claims questions
• Responding to inquiries in a timely and professional manner
• Assisting in the implementation of claims management system and providing guidance on enhancements
• Review and analyze expenses, including gathering and evaluating supporting documentation
• Working with outside vendors to obtain supporting documentation for expenses
• Participating in annual systems testing to ensure all automated processes within the department function with new software releases

Skills on Resume: 

• Claims Processing Expertise (Hard Skills)
• Policy and Coverage Knowledge (Hard Skills)
• Customer Service (Soft Skills)
• System Implementation and Enhancement (Hard Skills)
• Expense Review and Analysis (Hard Skills)
• Vendor Management (Hard Skills)
• Testing and Quality Assurance (Hard Skills)
• Attention to Detail and Analytical Skills (Soft Skills)

Job Summary:

• Ensure that all vendors have the necessary information to perform duties including the contact information for each other, contractors and client.
• Report GL loss to the appropriate insurance carriers with all relevant information and pleadings. 
• Advise what resources were deployed and the contact for each in accordance with project procedures.
• Verify indemnified parties before making an assignment to OCIP defense counsel on all OCIP programs.
• Assign defense to all legal matters and evaluate any potential conflicts of interest.
• Oversee the General Liability claims on the various programs by tracking the attorneys assigned and collecting status reports and updates.
• Collect initial documents including site investigation reports, photos, investigator’s report, etc.
• Establish and maintain a file system
• Assist insurance adjusters to obtain requested information related to claims on the program.
• Attend claim reviews, monthly staff meetings, and monthly litigation strategy meetings.
• Assist defense counsel in obtaining responses to discovery demands and other discovery related issues.
• Review and evaluate tenders of defense and whether parties are owed a defense under the insured’s insurance programs.

Skills on Resume: 

• Organizational Skills (Hard Skills)
• Communication Skills (Soft Skills)
• Legal and Compliance Knowledge (Hard Skills)
• Attention to Detail (Hard Skills)
• Project Management (Hard Skills)
• Collaboration (Soft Skills)
• Problem-Solving (Hard Skills)
• Analytical Thinking (Hard Skills)

Job Summary:

• Install cases on applicable systems
• Serve as a technical resource to business partners and co-workers
• Develop and improve existing processes and tools
• Test System for benefit accuracy
• Test plan product templates in TOPS
• Conduct peer review to validate benefit set-up
• Serve as a Tops technical resource for the Customer Implementation
• Respond to inquiries requiring research and functional knowledge of the impacts of the downstream operation
• Respond to customer service issues within established service metrics
• Contribute to the success of Customer Implementation through active team participation in new business Account Management Teams(s) and the Customer Implementation workgroup
• Develop and Improve Existing Processes and Tools
• Clearly and consistently track metrics and goals
• Share best practices with other workgroup members
• Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment).

Skills on Resume: 

• Technical Installation Skills (Hard Skills)
• Technical Resource (Hard Skills)
• Process Improvement (Hard Skills)
• Testing and Validation (Hard Skills)
• Peer Review (Hard Skills)
• Technical Expertise (Hard Skills)
• Problem Solving (Hard Skills)
• Team Collaboration (Soft Skills)

Job Summary:

• Investigate basic-level claims, including Worker’s Compensation, General Liability and other product lines. 
• Maintains accurate diary and proactive review of claims. 
• Responsible for claims results, including timely contact, investigation and disposition of claims. 
• Settles claims independently. 
• Achieves key metrics in alignment with risk finance objectives.
• Works closely with other team members in supporting the creation of risk and safety programs, training materials, and presentations to Operations. 
• Demonstrates ability to enroll Operations and SC departments to elevate risk management standards.
• Conducts presentations and store site inspections on safety issues. 
• Attends regional meetings and enrolls Operations compliance for safety programs. 
• Achieves positive feedback from Ops and SC Leaders. 
• Represent the company at Small Claims Court.
• Collects pertinent evidence for claims files. 
• Provides support for ad hoc reports. 

Skills on Resume: 

• Claims Investigation and Management (Hard Skills)
• Effective Communication (Soft Skills)
• Analytical Skills (Hard Skills)
• Time Management and Organization (Soft Skills)
• Problem-solving and Decision-Making (Soft Skills)
• Team Collaboration and Leadership (Soft Skills)
• Presentation and Training Development (Soft Skills)
• Regulatory Compliance and Safety Inspection (Hard Skills)

Job Summary:

• Receive new notices via phone, email, fax, or mail and set the new claim notice in the claim system
• Review notice materials and populate the claim system with proper line of business and coverage, enter loss description, cause of loss, losses arising out of & injury coding
• Provide after-hours loss notice reporting support and escalate new notices which necessitate immediate response and after-hours handling pursuant to a rotating schedule of after-hours support
• Make initial contact with policyholders to confirm loss description and identify primary contacts for loss investigation pursuant to loss type script
• Distribute new loss notices claims to company adjusters according to the assignment matrix and line of business, loss state, damage/injury type
• Request policies that are not in the claim system
• Handle retail agent, wholesale broker, policyholder or claimant calls on pending matters and provide assistance or status as needed
• Provide assistance on pending claim files of adjusters who are out of the office
• Prepare and study for and seek to obtain an Adjuster’s License and other non-resident reciprocal licenses as may be needed
• Request Certified policies and mentor new hires
• Process ISO and Medicare data and maintain CIS vendor 
• Communicate underwriting on a claim’s status
• Back-up claim administrative staff and perform other tasks

Skills on Resume: 

• Communication Skills (Soft Skills)
• Technical Proficiency in Claims Systems (Hard Skills)
• Organizational Skills (Soft Skills)
• Attention to Detail (Soft Skills)
• Problem-solving and Escalation Management (Soft Skills)
• Customer Service Orientation (Soft Skills)
• Regulatory Compliance and Licensing Knowledge (Hard Skills)
• Team Support and Mentorship (Soft Skills)