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Claim Operations Specialist

Company: Travelers
Location: Rancho Cordova
Posted on: March 24, 2020

Job Description:

Company Information

Solid reputation, passionate people and endless opportunities. That's Travelers. Our superior financial strength and consistent record of strong operating returns mean security for our customers - and opportunities for our employees. You will find Travelers to be full of energy and a workplace in which you truly can make a difference.

Job Summary

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.

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.

Primary Job Duties & Responsibilities

Customer Engagement: Serves as a customer service representative for the claim department by promptly and professionally addressing external and internal 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.
  • Corrects wage statements.
  • Requests police reports and medical records.
  • Reviews medical bills for proper billing and coding.
  • Prints and prepares claim documents for legal and medical reviews.
  • Reports claims to other insurance companies.
  • Assigns new claims to the appropriate claim professional.
  • Transitions closed files to and from off-site storage using records management systems.
  • Receives, sorts, scans, and uploads incoming mail.
  • Researches for the appropriate recipient.
  • Processes out-going mail, including overnight packages as needed.
  • 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 daily/monthly/quarterly and ad hoc 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.
        • Supports statutory reporting requirements.

          Other duties as assigned.

          Minimum Qualifications

          High School Diploma or GED with one year of work or customer service related experience OR Bachelor's Degree required.

          Job Specific & Technical Skills & Competencies

          Accountability: Takes ownership and responsibility for actions and outcomes, performance and results; Intermediate proficiency. Analytical Thinking: Identifies current or future problems or opportunities, analyzes, synthesize and compares information to understand issues, identifies cause/effect relationships and explores alternative solutions to support sound decision-making; Basic Proficiency Change Management / Resilience: Remains energized and focused in the face of ambiguity, change or strenuous demands; Intermediate proficiency. Communication Skills: Good verbal and written and listening communication skills including telephone protocols; Basic Proficiency. Customer Focus: Provides service excellence to internal or external clients; Basic Proficiency Judgment / Decision Making: Exercises sound judgment makes decisions and commits to a position; Basic Proficiency Relationship Management: Seeks out, builds, fosters and maintains productive relationships, networks or alliances to meet goals and achieve results; Basic Proficiency Teamwork: Works together in situations when actions are interdependent and a team is mutually responsible to produce a result; Basic Proficiency Time Management: Ability to prioritize, highly organized, able to multi-task in order to meet deadlines; Basic Proficiency.

          Environmental/Work Schedules/Other

          Other: Travel - Occasionally Occasional overtime based on business need.

          Physical Requirements

          Operates standard office equipment - continuously Sitting (can stand at will) - continuously Standing (can sit at will) - continuously Lifting items up to 25 pounds - frequently Use of Keyboards, Sporadic 10-Key - continuously Working in a confined or restricted area - occasionally Driving - occasionally for training or business travel Other: Pushing and pulling of mail carts, up to 25 pounds, several times per day.

          Equal Employment Opportunity Statement

          Travelers is an equal opportunity employer.

Keywords: Travelers, Rancho Cordova , Claim Operations Specialist, Other , Rancho Cordova, California

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