Job Summary:

• Enter and manage health claims to ensure timely payment for providers and members.
• Research and compile information from various sources to resolve inquiries and claim discrepancies, consulting with senior staff if assistance
• Respond to inquiries from internal customers regarding all aspects of health benefits and claims assessment.
• Follow through to ensure effective and efficient resolution of all inquiries.
• Contact providers and members to obtain the necessary information to assess claims.
• Adjudicate claims in accordance with unit procedures and Health Services standards with a high degree of accuracy and efficiency.
• Monitor individual production to ensure that claim turnaround and volume expectations are met.
• Make suggestions to improve workflows and processes.
• Processing new claims, arranging estimators and submitting quotes while adhering to KPIs
• Maintaining a high level of communication with all stakeholders
• Liaising with insurance companies mostly through online portals and email
• Updating ongoing notes to Internal and Client systems

Skills on Resume: 

• Health Claims Processing (Hard Skills)
• Research and Problem Solving (Hard Skills)
• Customer Service (Soft Skills)
• Issue Resolution (Hard Skills)
• Communication Skills (Soft Skills)
• Adjudication Skills (Hard Skills)
• Monitoring and Compliance (Hard Skills)
• Process Improvement (Hard Skills)

Job Summary:

• Reviewing and sending the appropriate acknowledgement email for all new claims tickets.
• Confirming all required documents have been provided with each claim submission.
• Liaising with customers and veterinary practices ensuring all relevant documents are logged.
• Acting as the primary contact for all new claims.
• Determining the type of claim submitted and route to the appropriate workflow for processing.
• Adhering to company, legal and regulatory (DOI) policies and procedures to ensure compliance with requirements.
• Participating in the development and training of peers to ensure adequate cross-functional operations coverage.
• Identifying and communicating potential trends, issues, or risks and escalate appropriately.
• Providing support to policyholders to promptly resolve questions.
• Managing a broad range of customer queries and requests through various channels providing a professional and helpful service and effective customer communication.
• Championing product and process improvements to benefit the overall customer experience.
• Delivering superb customer service in line with operational goals.

Skills on Resume: 

• Customer Service Excellence (Soft Skills)
• Claims Management (Hard Skills)
• Regulatory Compliance (Hard Skills)
• Documentation and Logging (Hard Skills)
• Problem Resolution (Soft Skills)
• Training and Development (Soft Skills)
• Communication Skills (Soft Skills)
• Process Improvement (Hard Skills)

Job Summary:

• Capturing and sharing workflow MI
• Uploading workflow demand to MS Teams
• Reallocation of unallocated claims to ensure they are assigned to relevant claims handlers
• Attending daily Operational Huddles and providing workflow related updates
• Regularly reviewing mailbox to ensure that real time requests are planned
• Collaborative working with Real Time team
• Supporting operation with a variety of actions during surge events
• Allocation of absence and holiday tasks and monitoring task clearance real time to support clearance
• Support Operation where required by keying absence, emergency holidays, ADHOC requests etc
• Working within a small team split across site communication skills are essential
• Supporting Real Time team across Newport and Copley sites with ADHOC requests

Skills on Resume: 

• Workflow Management (Hard Skills)
• Microsoft Teams Proficiency (Hard Skills)
• Claims Reallocation (Hard Skills)
• Operational Updates (Hard Skills)
• Real-Time Response (Hard Skills)
• Collaboration Skills (Soft Skills)
• Surge Event Support (Hard Skills)
• Task Allocation and Monitoring (Hard Skills)

Job Summary:

• Support, facilitate and coordinate the work of multiple project managers
• Identify and remove barriers to successful completion of mitigation claims
• Serve as the primary point of contact with external vendor representative, insurance adjusters, project managers and customers
• Assemble emergency services estimates when needed
• Monitor mitigation dashboard to ensure accuracy and proper workflow
• Document all job communications and notes in Restore
• Monitor and track all TPA Service Level Agreements
• Maintain project work schedules and files
• Assist field teams with completing exceptions/change requests on submitted estimates
• Facilitate customer warranty and satisfaction surveys
• Be available to assist with Emergency or CAT situations after hours

Skills on Resume: 

• Project Management (Hard Skills)
• Problem Solving (Hard Skills)
• Communication (Hard Skills)
• Estimation (Hard Skills)
• Monitoring and Reporting (Hard Skills)
• Documentation (Hard Skills)
• Organization and File Management (Hard Skills)
• Customer Service (Soft Skills)

Job Summary:

• Obtain information from insured or designated persons, by telephone and email
• Respond to telephone, online, and written inquiries promptly
• Enter claims information into database systems with superb attention to detail
• Accurately prepare and review insurance claim forms
• Download, upload, create, use naming conventions for a variety of supporting PDF and jpg files
• Respond to the service needs of insured, clients, adjusters, field personnel, and home office employees
• Ability to work in a fast-paced environment and manage changing priorities effectively
• Process policy level transactions within level of authority
• Conduct research when needed to complete requests
• Prepare daily reports utilizing various databases and Excel
• Communicate and cooperate with co-workers, management, clients, vendors, and others in a courteous and professional manner

Skills on Resume: 

• Effective Communication Skills (Soft Skills)
• Prompt Inquiry Response (Hard Skills)
• Data Entry Accuracy (Hard Skills)
• Claims Processing Expertise (Hard Skills)
• File Management (Hard Skills)
• Customer Service Orientation (Soft Skills)
• Adaptability and Prioritization (Soft Skills)
• Research and Reporting (Hard Skills)

Job Summary:

• Collect and compile data received from various sources
• Analyze and consolidate data quickly to create accurate written reports
• Provide a complete published report to the customer within specified deadlines
• Communicate with customers by telephone and/or email to resolve problems
• Participate as a key team player by supporting department functions and goals
• Coordination of the exchanges of goods and returns of goods on commission
• Creating shipment and customs documents, packing the returns as well as controlling the reviewed returns
• Processing of credit notes and preparation of the monthly statements
• Protect the organization's value by keeping information confidential
• Support workload surges and/or Catastrophe operations to include working significant overtime during designated catastrophes

Skills on Resume: 

• Data Collection and Compilation (Hard Skills)
• Data Analysis (Hard Skills)
• Report Writing (Hard Skills)
• Customer Communication (Soft Skills)
• Team Collaboration (Soft Skills)
• Logistics Coordination (Hard Skills)
• Financial Processing (Hard Skills)
• Confidentiality (Soft Skills)

Job Summary:

• Manage shared mailbox receiving a high volume of loss correspondence
• Analyze key attributes within correspondence for the appropriate business unit and/or MRAm department
• Evaluate and rank as Payment, Cash Call, Recovery, ACH inquiry First Notice of Loss, Update, Litigation/Suit, Encryption, etc. to meet time sensitive Service Level Agreements assigned to each category.
• Analyze each loss correspondence using Reinsurance reference materials and structural guides to identify the appropriate Claims Specialist / Claims Handler (includes branches)
• Provide the accurate line of business and MRAm loss number
• Determine the appropriate course of action and route the correspondence to internal/external clients using Workflow, email or alternative per Claim Handling Guidelines and/or Claim Coordinator Working Model.
• Prepare and refine loss correspondence in Reinsurance applications and facilitate with IT the appropriate access to MRAm's secured FTP site for legal counsel's review.
• Manage and prepare hard copy/CD Claim correspondence by consulting with the Claims Divisions, and/or Micrographics supporting paperless environment.
• Manage critical customer service operations (i.e. - printer maintenance, shipment of federal express, certified mailings, office supplies. 
• Elevate to manager areas identified for improvement to ensure a high caliber of customer service.
• Assist with the Claim Handler's responsibilities during peak intervals.

Skills on Resume: 

• Email Management and Communication (Hard Skills)
• Analytical Skills (Hard Skills)
• Knowledge of Reinsurance (Hard Skills)
• Workflow Management (Hard Skills)
• Technical Proficiency (Hard Skills)
• Document Management (Hard Skills)
• Customer Service Orientation (Soft Skills)
• Problem-Solving and Initiative (Soft Skills)

Job Summary:

• Setting up new claims in TAM broker management system
• Confirming and updating TAM with adjuster assign details and claim number
• Advising Underwriters of new claim submissions
• Ensuring that all subscribers are advised of new claim
• Maintaining reserves in TAM (including noting and attaching subrogation and cheques)
• Monitoring Large loss notifications and advising Underwriters and Executive Management
• Scanning of all opening and closing notices and attaching to TAM
• Closing of all files ensuring that fees/payments from all subscribes are recorded to TAM before closing
• Handling all incoming calls from brokers, Third Party Administrators (TPA), and/or Underwriters assisting with queries.
• Formal Loss runs from TAM to brokers
• Contacting Adjusters/TPAs for current status on file i.e. payment/reserves etc.

Skills on Resume: 

• Proficiency in TAM (Hard Skills)
• Claims Management (Hard Skills)
• Communication Skills (Soft Skills)
• Attention to Detail (Soft Skills)
• Monitoring and Reporting (Hard Skills)
• Customer Service (Soft Skills)
• Organization and Time Management (Soft Skills)
• Problem Solving (Soft Skills)

Job Summary:

• Completing and sending off E&O forms to HUB Corporate for all SOC where Totten is named and advise Executive Management
• Providing TPAs/Adjusters/Brokers with wordings
• Processing all cheque requests received from TPA. 
• Enter requests in TAM, ensuring reserves are updated and send off activity to Accounting.
• Entering all payments in Lineage if it is a scheme Canada contracts ensuring that all reserves and updated in lineage
• Following up with Lloyds on all payments still pending approval on Lineage
• Entering in all scheme advances in Lineage and contact Lloyds to seek approval from the system
• Ensuring that the payment is linked in lineage once the funds have arrived and seek Underwriter approvals
• Assisting Finance with reconciliation of working paper. i.e. ensuring that all stale dated cheques are followed up on, all outstanding payments have been requested and that all payment entered on Lineage have been approved
• Works with accounting to ensure that the bordereaux and accounting slip match. 
• Ensuring accurate completion from Underwriting Assistant and create summary and send off to
• Reporting all E&O claims to Claims Director for further action/oversight
• Maintaining updated claims spreadsheet

Skills on Resume: 

• Attention to Detail (Hard Skills)
• Organizational Skills (Hard Skills)
• Communication Skills (Soft Skills)
• Technical Proficiency (Hard Skills)
• Problem-Solving Abilities (Hard Skills)
• Analytical Skills (Hard Skills)
• Team Collaboration (Soft Skills)
• Adaptability and Flexibility (Soft Skills)

Job Summary:

• Responds to requests for first-level support/general technical assistance in via phone, and e-mail.
• Diagnoses and resolves technical hardware and software issues.
• Assists all customers with their questions about any of supported software, applications and computing platforms, to the best of his/her ability, in a professional and courteous manner.
• Creates submitter accounts, manages and configures those accounts, and deletes accounts due to non-activity. 
• Timely and accurate data entry of Account Request forms
• Safeguards system account password information and has access to verbal, written and/or electronic protected healthcare information as defined by HIPAA and Beacon Health Options.
• Stays abreast of current news, system information, problems, changes and updates relevant to user community.
• Researches questions using a variety of manuals and resources.
• Familiarize themselves with the research and information resources and knowledge bases at hand.
• Finds answers to all questions addressed to them personally or with assistance.

Skills on Resume: 

• Technical Support (Hard Skills)
• Problem Diagnosis and Resolution (Hard Skills)
• Customer Service (Soft Skills)
• Account Management (Hard Skills)
• Data Entry (Hard Skills)
• Confidentiality Compliance (Hard Skills)
• Knowledge Management (Hard Skills)
• Research and Resource Utilization (Hard Skills)

Job Summary:

• Working with internal and external customers for inquiry resolution.
• Interfaces with Service Centers, Corporate Departments and all Beacon Health Options staff
• Maintain close working relationships with all to ensure the highest level of customer satisfaction is met.
• Advises user on appropriate action for customer resolution.
• Tracks and routes problems and requests and document resolutions.
• Identifies and escalates situations requiring urgent attention.
• Applies critical thinking skills to problem situations and excels in an environment with a high level of ambiguity.
• Follows Help Desk procedures and unit processes.
• Work projects as identified by management to support business needs.
• Attaching all related email/documents pertaining to the claim

Skills on Resume: 

• Customer Inquiry Resolution (Hard Skills)
• Interdepartmental Collaboration (Hard Skills)
• Relationship Management (Soft Skills)
• Advisory Role (Hard Skills)
• Problem Tracking and Documentation (Hard Skills)
• Issue Escalation (Hard Skills)
• Critical Thinking (Soft Skills)
• Process Adherence (Hard Skills)

Job Summary:

• Review injuries with the intent to provide a detailed claim and injury summary
• Conduct monthly claims reviews, process workers compensation and salary continuance invoices
• Manage service providers to ensure the highest level of service is received
• Provide guidance and expertise to internal and external stakeholders regarding claim issues, strategies and financial implications
• Provide timely and accurate claims administration and processing of relevant documentation
• Work closely with the Claims and safety teams toward improvements in safety performance and culture
• Locate, collect and coordinate records, policies, and other documents required in connection with claims.
• Review the matter and acquire supporting documentation to commence a claim.
• Coordinate and liaise with other departments within the Company, including Customer Care and Damage Prevention, and gather evidence to support claim or defense.
• Correspondence with international suppliers regarding the processing of complaints, including the evaluation of the goods
• Close cooperation with Incoming Goods Team
• Negotiations about discounts, SOR and/or valuta in coordination with the Buying Team

Skills on Resume: 

• Claims Management (Hard Skills)
• Workers Compensation (Hard Skills)
• Vendor Management (Hard Skills)
• Stakeholder Communication (Soft Skills)
• Claims Administration (Hard Skills)
• Safety Improvement (Hard Skills)
• Document Management (Hard Skills)
• Cross-functional Coordination (Soft Skills)

Job Summary:

• Making sure that samples are provided to all vendors to support the claims being filed
• Communicate with vendors to ensure claims are being handled in acceptable timeframes
• Reconcile receipt of credits from submitted claims, and post-credits in the system
• Provide field support on all claims in question, and provide guidance
• Run Monthly Claims Reports and distribute them to each WBS branch
• Type in claims data provided from customers
• Point of contact for all customer claims
• Analyze and process all residential flooring claims and process returns associated with claims
• Identify and schedule site visits for inspectors
• Understand warranties and facilitate for all product categories
• Support various warranty programs through multiple channels

Skills on Resume: 

• Claims Management (Hard Skills)
• Vendor Communication (Soft Skills)
• Financial Reconciliation (Hard Skills)
• Field Support and Guidance (Soft Skills)
• Reporting Skills (Hard Skills)
• Data Entry (Hard Skills)
• Customer Service (Soft Skills)
• Analytical and Process Management (Hard Skills)

Job Summary:

• Gathering and Investigating of Vehicle Damage Claims
• Interacting with both internal and external customers to follow up for Damage documentation
• Sending complete damage package to the insurance company
• Maintain database of all damage reports
• Constant correspondence and follow-up with the maintenance department to obtain the vehicle damage estimates
• Handle incoming inquiries from third party providers
• Monitoring incoming accidents from the off-airport locations and ensuring all required documentation is attached
• Work with Microsoft Access Database, Excel, PowerPoint and Outlook on a daily basis
• Working with two rental systems for the purpose of gathering or documenting information
• Attend Small Claims Court settlement conferences and prepare for and conduct trials.
• Support department lawyers with Superior Court litigation including drafting statements of claim and defense for review by senior legal counsel.
• Manage and report on data analytics and litigation results including cost savings and debt recovery.

Skills on Resume: 

• Claims Handling (Hard Skills)
• Customer Interaction (Soft Skills)
• Database Management (Hard Skills)
• Communication Skills (Soft Skills)
• Software Proficiency (Hard Skills)
• Rental Systems Knowledge (Hard Skills)
• Legal Support (Hard Skills)
• Data Analytics and Reporting (Hard Skills)

Job Summary:

• Conducts interviews with policyholders and third parties to explain procedures for filing claims.
• Gives instructions and advice on how to proceed after a claim is filed.
• Utilizes the claim search mechanisms to review new and existing claims.
• Assists claim handlers with obtaining and evaluating reports that will assess exposure, reserves, and resolution strategy.
• Assists in the resolution of property and liability claims.
• General administrative and technical support to claim handlers.
• Prepares various management reports at the request of management.
• Prepares claim status reports for the major loss meetings.
• Assists management in preparing for the various umbrella and reinsurance audits.
• Works closely with all claim handlers and department

Skills on Resume: 

• Communication Skills (Soft Skills)
• Claims Processing Knowledge (Hard Skills)
• Analytical Skills (Hard Skills)
• Problem-Solving Skills (Soft Skills)
• Administrative Support (Hard Skills)
• Report Preparation (Hard Skills)
• Audit Preparation (Hard Skills)
• Team Collaboration (Soft Skills)