Insurance Admin Representative, Unlicensed
COVU
Claims Specialist - Accident & Health
QBE Insurance
full-time
Posted on:
Location: Massachusetts • 🇺🇸 United States
Visit company websiteSalary
💰 $83,500 - $125,500 per year
Job Level
Mid-LevelSenior
About the role
- Provide exceptional claims service to customers by managing complex medical stop loss claims effectively
- This includes assessing policy coverage, investigating, evaluating, and negotiating claims, as well as collaborating with suppliers and stakeholders while offering technical support
- Support the implementation of the Claims strategy to enable the delivery of overall business targets
- Maintain current knowledge of insurance guidelines, policy changes, and modifications
- Maintain good client relationships with insured individuals, agents, service providers, and the general public
- Provide claim management for various types of insurance claims
- Identify and implement strategies to minimise Claims Costs and Leakage
- Respond to client requests following service standards
- Assist with the negotiation of claims settlements
- Participate in relevant meetings to share and develop strategy, knowledge, and best practices
- Identify and resolve issues or anomalies non-compliant with policies and procedures
- Assist with the daily review of reports and ad hoc reporting
- Mentor and coach junior staff as required
Requirements
- Moderate relevant experience
- Experience in an Accident & Health claims department or the insurance industry
- Experience handling Medical Stop Loss claims
- Tertiary Degree or equivalent combination of education and work experience
