Generali Global Assistance

Claims Specialist

• This position is responsible for analyzing and processing insurance claims to determine the extent of the insurance carriers liability in a manner that supports the mission, values, and standards of the Company.
• Primary responsibilities include efficient adjudication of insurance claims, both phone and written communication with insureds, travel suppliers, medical facilities, and others, as well as maintaining all state Department of Insurance regulations for claims files.
• Claims Processing and Coordination: Process all claims assigned in a timely, efficient, and accurate manner ensuring that all appropriate policies, procedures, and standard best practices are being followed.
• Review information on claim forms, Physician Statements, and other documentation to ascertain completeness and validity of claims.
• Correspond with insureds, physicians, agents, and other appropriate parties to obtain proper documentation and to finalize claims.
• Maintain proper reserves on each claim file.
• Ensure that proper file documentation is collected and maintained, including all records of correspondence and telephone conversations.
• Investigate claims and direct the activities of outside adjusters and investigators.
• Issue denial of benefits letters when appropriate.
• Process attorney represented claims files.
• Review and respond to Department of Insurance complaint letters.
• Respond to written and phone inquiries regarding claims status.
• Issue payments in a timely and accurate manner.
• Ensure that current Federal and State insurance claims regulations, laws, and best practices are being employed consistently for all jurisdictions.
• Customer Service: Answer questions and respond to inquiries from internal and external customers regarding coverage issues and general policy information.
• Teamwork and Department Support: Assist in the mentoring and training of other employees as directed. Perform other duties or special projects as assigned by the management team.

Claims Representative

Operations

• Responsible for the day-to-day operations of the GGA Travel Assistance department, including the provision of effective, quality-driven assistance services to our customers.
• Responsible for workforce management, performance management, quality management, and knowledge management within an environment of 30+ employees.
• Works closely with the Medical team, Claims teams and other internal and external stakeholders.
• This role reports to the Director of Customer Service.
• Manage the day-to-day operations of Travel Assistance, including the provision of effective, quality-driven assistance services to our customers
• Partners closely with Travel Assistance Medical team, working together to establish processes with smooth handovers and focus on customer experience and safety
• Partners with the Europ Assistance groups Travel/Medical Assistance team leaders to identify improvement opportunities and contribute to process development
• Maintain close management of operational tasks to deliver timely service and positive case outcomes
• Manage staff; define and assign work; monitor activities; and evaluate the performance of all offerings and/or services provided by Travel Assistance
• Execute against established key performance indicators (KPIs) to achieve department objectives in regard to quality, productivity, and team performance to ensure that they adhere to expected process and timeline according to company objectives
• Provide coaching and guidance to staff and promote staff training and development.
• Oversee regular coaching sessions to review escalated calls/cases, training opportunities, and individual performance metrics
• Monitor individual performance metrics and team performance reports daily, weekly, and monthly to ensure that productivity and quality objectives are met
• Manage the development, tracking, and reporting of key performance and productivity measurements for the department
• Support with the processing of Travel Assistance claims
• Build and maintain vendor relationships
• Act as an escalation point for sensitive customer and partner issues, including the management, investigation, and resolution of escalated incidents and complaints, escalating to the Director of Customer Service when necessary
• Manage regular quality control reviews on active and inactive cases
• Generate monthly reporting on call and case management statistics and quality data at senior management meetings and client meetings as required
• Identify and address staff training and coaching needs and partners with Ops Development to create training for new TA staff and provides ongoing training for CSD team members when needed
• Perform annual performance reviews for Supervisors and Assistance Coordinators
• Guide and offer recommendations to the Director, CSD as to changes in personnel, hiring, employee development, quality, performance, productivity, and adherence to company values and objectives
• Motivate staff, create a culture of excellence and promote a can-do attitude within the department
• Stay informed of relevant processes and procedures by periodical training
• Perform other responsibilities and assignments as assigned

Senior Operations Manager

Customer Support

• Answer inbound calls and automated call backs, assisting clients with coverage questions, policy modifications or cancellations, claim filing, claims status requests, etc.
• Make outgoing calls following up on customer requests
• Provide information on travel protection plans to travel agents or directly to passengers.
• Documents all interactions with passengers.
• Attends weekly team meeting to stay abreast of product information, and procedural/policy changes and department or company updates?
• Participate in individual and group training, complete mandatory company training within deadlines.
• Follows proper procedures as detailed in performance guidelines, and representing the mission statement, values, and standards of Generali
• Manages personal email inbox to stay informed of company and departmental updates
• Any additional tasks assigned by management.

Customer Service Representative – Emergency Services

Artificial Intelligence

• The Sr AI Digital Operations Specialist oversees the efficiency and development of Generali's digital assets.
• Responsible for implementing digitization initiatives, overseeing their implementation, and evaluating their effectiveness.
• Focus on enhancing existing digital assets and identifying and deploying new assets with a strong focus on AI.
• Analyzing market data and interacting with internal and external stakeholders.
• Lead digital initiatives, including identifying and prioritizing projects and overseeing project execution.
• Develop and implement solutions to digitize services with a focus on Operations.
• Collaborate closely with Operations, IT, and third-party technology partners to leverage data and reporting, optimize efficiencies, and drive improvements using technology.
• Ongoing research of potential use cases for Generative AI technologies and implementation at scale, including KPI monitoring, efficiency optimization and impact measurement.
• Manage process optimization and automation tools, including modifying workflows within existing or future tools.
• Responsible for delivering digital/automation roadmaps by mapping company needs with available technology, with strong focus on AI.
• Analyze and evaluate existing business processes and digital solutions to identify areas for automation and improvement.

Claims Representative

Senior Operations Manager

Customer Service Representative – Emergency Services

Senior AI Digital Operations Specialist