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Senior Associate Claims Operations

  • Posted 3 hours ago
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Job Description

Primary DetailsTime Type: Full timeWorker Type: EmployeeThe purpose of this role is to support internal and external customers by responding to claims file inquiries, handling higher complexity and escalated claims, maintaining accurate documentation and following established guidelines to ensure alignment with corporate objectives and achieve department success.

Responsibilities:

  • Provide claims customer service support by answering inbound calls as needed, responding to claims file inquiries and escalating issues to appropriate claims staff to contribute to customer satisfaction and effectiveness of service
  • Handle claims by gathering and evaluating relevant information, mailing claims items, maintaining accurate documentation, tracking claims files and resolving outstanding issues to ensure alignment with corporate standards and government regulations
  • Support internal and external customers by processing and balancing check registries, understanding claims processes and procedures, following established guidelines and identifying opportunities for process improvement to align individual performance with department objectives
  • Communicate claims file status and details by sharing relevant information with claimants, insured parties, vendors, specialists, agents and other employees as needed and verifying data to support delivery of effective customer service
  • Maintain a claim payment register to balance to claims system
  • Access, review and authorize claim bank accounts to ensure accuracy against payments
  • Cultivate claims support skills and knowledge by seeking advice and guidance of peers and participating in cross-training as required to learn additional processes and increase personal effectiveness
  • Obtain insurance information on behalf of clients by placing outbound calls to agents, carriers, or borrowers as assigned and entering collected data to achieve productivity and quality metrics and ensure account information is complete, accurate and current
  • Build customer service knowledge by taking initiative for learning additional processes, queues and client-specific procedures to support customers in secondary areas and provide comprehensive, well-informed responses to inquiries
  • Maintain a strong knowledge base of all processes to complete peer reviews of completed work and to provide feedback on the quality of the work to the manager/supervisor and to ensure that process protocols are being followed
  • Identify risks to change implementation by supporting coordination and execution of user acceptance testing for upcoming process changes to ensure alignment of updates with desired outcomes
  • Assist with the identification of training requirements for assigned projects and business units by providing input to the training plan, supporting the development of training materials and participating in the training for assigned projects as required

Work Experience:

Necessary Work Experience includes:

  • Some relevant work experience.

Preferred Work Experience includes:

  • Basic claims knowledge and understanding of insurance

Qualifications:

Preferred Qualifications include:

  • Tertiary Education

Global Disclaimer:

The duties listed in this job description do not limit the assignment of work. They are not to be construed as a complete list of the duties normally to be performed in the position or those occasionally assigned outside an employee's normal duties. Our Group Code of Ethics and Conduct addresses the responsibilities we all have at QBE to our company, to each other and to our customers, suppliers, communities and governments. It provides clear guidance to help us to make good judgement calls.

US Only Disclaimer:

To successfully perform this job, the individual must be able to perform each essential job responsibility satisfactorily. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential job responsibilities.

Travel Frequency:

Infrequent (approximately 1-4 trips annually)

US Only - Physical Demands:

General office jobs: Work is generally performed in an office environment in which there is not substantial exposure to adverse environmental conditions. Must have the ability to remain in a stationary position for extended periods of time. Must be able to operate basic office equipment including telephone, headset and computer. Incumbent must be able to lift basic office equipment up to 20 lbs.

Skills:

Claims Administration, Communication, Critical Thinking, Customer Service, Data Entry, Detail-Oriented, Document Management, Insurance Claims Processing, Intentional collaboration, Managing performance, Microsoft Applications, Prioritization, Problem Solving, Risk Assessments, Time Management

How to Apply:

To submit your application, click Apply and follow the step by step process.

Equal Employment Opportunity:

QBE is an equal opportunity employer and is required to comply with equal employment opportunity legislation in each jurisdiction it operates.

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About Company

Job ID: 151758689