Claim Operations Specialist. Job in Diamond Bar LilyLifestyle Jobs

Claim Position Under moderate supervision, this position is responsible for partnering with claim professionals to assist customers. Responsibilities within the team include building customer relationships, completing financial transactions, updating and managing important business information, and handling numerous other duties and projects. This position does not manage others. As part of the hiring process, this position requires the completion of an online pre‑employment assessment. Further information regarding the assessment including an accommodation process, if needed, will be provided at such time as your candidacy is deemed appropriate for further consideration. 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.

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.

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.

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.

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. What Will Our Ideal Candidate Have? Experience utilizing computer technology such as Microsoft Office, e-mail, Web-enabled applications, and database software. ACCOUNTABILITY: Takes ownership and responsibility for actions and outcomes, performance and results. ANALYTICAL THINKING: Ability to analyze and compare information to understand issues and explore alternative solutions. CHANGE MANAGEMENT/RESILIENCE: Ability to remain energized and focused in the face of ambiguity, change or strenuous demands. COMMUNICATION SKILLS: Verbal and written communication skills. JUDGMENT/DECISION MAKING: Ability to exercise sound judgment and make decisions. RELATIONSHIP MANAGEMENT: Ability to seek out, build, foster and maintain productive working relationships to meet goals and achieve results. What is a Must Have? High School Diploma or GED. 1 year of service-related work experience OR Bachelor's Degree. What Is in It for You? Health Insurance: Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment. 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. Paid Time Off: Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays. 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. 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. Employment Practices Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences. In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions. If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email so we may assist you. Travelers reserves the right to fill this position at a level above or below the level included in this posting. #J-18808-Ljbffr United Cerebral Palsy of Georgia