Claim Adjuster

JOB DESCRIPTION

Combined Insurance, A Chubb company, is seeking a Claim Adjuster to join our fast-paced, high energy, growing company.

We are proud of our tradition of success in the insurance industry of nearly 100 years.

Come join our team of hard-working, talented professionals!

POSITION SUMMARY:

The Claims Adjuster is a role in a high-energy, fast-paced, changing environment.

The Claims Adjuster is responsible for contacting claimant and /or service providers to request information needed in order to process claim - includes written correspondence and phone calls.

They will evaluate claims based on documentation received including responses from claimant and providers.

Will need to handle multiple priorities simultaneously, be self-directed and meet service level expectations.

The adjuster must demonstrate customer centricity in all aspects of their job by performing actions with empathy and expertise.

RESPONSIBILITIES:


* Efficiently and accurately adjudicate claims in accordance with the policy terms, established guidelines and regulations.


* Conduct eligibility claim review by evaluating claim submission and comparing to policy benefits.


* Request additional information from policyholders, providers and others as necessary to finalize claim.


* Actively manage inventory and ongoing claim adjudication.


* Effectively communicate with customers using empathy and professionalism via phone and written correspondence.


* Interface with Policyholders and Agents answering a variety of questions through different service channels.


* Develop a broad understanding of our products and systems.


* Meet Department standards for time, service and quality.


* Ability to maneuver between system applications confidently to find information and respond to customer needs in a timely manner.


* Collaborate with other team members and leadership to ensure effective customer service.


* Actively engage in Continuous Improvement initiatives and identify process and efficiency enhancements.


* Participate in required training


* Performs other duties as assigned

SKILLS:


* Exceptional written and verbal communication skills


* Quality and Customer Centric Orientation


* Excellent organizational skills


* Ability to multi-task in fast-paced environment with attention to detail and prioritize tasks


* Analytical skills and good decision-making skills


* Proficient in MS Office - Outlook, Word and Excel


* Navigation between systems and use of technology is important


* Insurance/Claims Experience


* Windows based PC Knowledge


* Bilingual in Spanish and English a plus

EDUCATION AND EXPERIENCE:


* 3 or more years related claims experience required (disability management and critical care desired)


* Experience in a customer interfacing position with progressive responsibility in role


* Knowledge of medical terminology

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