Insurance Claims Processor

Industry

Insurance

Advert ID

USA_445775

Location

Jacksonville

Job Type

Contract

Hours

Full-Time

Salary Range

No. of Openings

1

Branch Information

Jacksonville, FL - (USA) 9823 Tapestry Park Circle Suite 10 FL Jacksonville , FL - 32246 Phone : 904-807-9608

ContactNumber

904-807-9608

Job Description

Description: Allstate Title: AB-National Acct Claims-Sr Assoc

Pay Rate: $15.50/hr.

Work Address: 1776 AHL Drive Jacksonville, FL 32246

Work Schedule: Mon - Fri 11:00AM to 8:00 PM



Job Description: Must be Bilingual

This position is responsible for analyzing and adjudicating National Account Case Claims and provides customer service support to the Associates of these National Accounts.



Job Summary

This position is responsible for answer calls and analyzing/adjudicating National Account claims in accordance with policy provisions. A National Account Claims Associate must have the ability to interpret and apply laws, rules and regulations as well as evaluate claims from initial report to final determination. They must document claim and customer service files with notes and help the Unit achieve the Service Level Requirements as set forth by each of the National Account Groups. The position also requires a highly trained individual to take telephone calls from National Account Customers and answer complex customer inquries regarding their coverages.



Key Responsibilities

1) National Account Claims Examiners are responsible for analyzing, processing, researching, adjusting and adjudicating claims which will result in a payment or non payment of a claim.

2) Examiners review insurance policies, the claim form and supporting documentation to make sure that all of the information is correct. They determine whether the claims are covered under the policies issued to that policyholder.

3) Examiner assists in identifying, investigating and reporting fraudulent claim activity to our internal fraud unit.

4) Examiners are required to provide the insured with correspondence that is clear, concise and meets state regulations in relation to the decision they made on the claim processed.

5) Answer incoming National Account customer inquiries and respond to customer requests. Have the ability to answer complex questions and interpret a variety of policies, rules, regulations and performs a full range of customer service duties.



Knowledge/Skills/Abilities/Experience

* Must have a demonstrated track record and the ability to work in a fast paced/deadline driven environment.

* Ideal candidate should be able to work independently or in a team oriented environment.

* Must have the ability to interpret and apply laws, rules and regulations.

* Limited policy coverage and insurance regulation knowledge

* Verbal/written telephone communication skills are a must

* Attend training sessions as a participant

* Limited individual decision making

* Simple and straight forward individual claim authorization

* Ability to prioritize and handle multiple tasks