Claim Operations Associate I/Claim Operations Associate II

• →Begin developing a working knowledge of the claim operation and learn to resolve routine incoming operations partners’ requests

• →Perform claim operations and payment functions for one or more lines;

• →Complete new loss establishment within the claim system, including statistical coverage verification and document upload to electronic claim filing system

• →Complete financial transaction support for either loss or expense payments, loss or expense reserves, loss or expense refunds

• →May perform systems functions, including determining errors/corrections on claims system(s).

• →Update claim files and maintains, corrects and/or updates data using office technology

• →Learns basic claim handling and how support is necessary

• →Composes, prepares, reviews, and responds to correspondence including inquires that may take additional research prior to responding

• →Perform mail functions including research to identify recipient for misdirected mail within the company or externally

• →Exhibits ability to use appropriate resources necessary to complete support requirements

• →Exhibits ability to actively seek information to understand operations partners’ circumstances, problems, expectations and needs, for the purpose of resolving inquiries/issues

• →Shares and/or conveys information to business partners, regarding their claims; maintains a professional demeanor in all situations.

• →Becomes familiar with and utilizes computerized systems for policy analysis, claims operations requirements and related data management systems, information gathering and/or troubleshooting.

• →May provide assistance to Claims department in areas requiring beginner to intermediate skills or knowledge.

• →May assist in training less experienced Claim Operations Professionals

• →Complies with company and regulatory guidelines

• →Performs all other duties as assigned

• →Participate in industry based continued education

Education: High school diploma or equivalent

Experience: 0-5 years of related experience

Performs work under supervision. Demonstrates beginner to intermediate knowledge of forms/systems, policy analysis, claim operations requirements and related management systems.