Claims Representative

• A diverse, inclusive, professional work environment
• Flexible work schedules
• Company match on 401(k)
• Competitive Paid Time Off policy
• Generous Employer contribution for health, dental and vision insurance
• Company paid short term and long term disability insurance
• Paid Maternity and Paternity Leave
• Tuition reimbursement
• Company paid life insurance
• Employee Assistance program
• Wellness programs
• Fun employee and company events
• Discounts on travel insurance

Who are we?

Generali Global Assistance is proudly part of the Europ Assistance Group brand and our products utilize a number of corporate and product brands. The brands for our North American team include the following:

• CSA: US travel insurance brand for retail and lodging partners. Learn more here.
• Generali Global Assistance (GGA): The primary Corporate brand in the United States for our travel insurance, travel assistance, identity and cyber protection, and beneficiary companion products. Learn more here.
• GMMI: the industry standard for global medical cost containment and medical risk management solutions. Learn more here.
• Iris, Powered by Generali: identity and digital protection solution. Learn more here.
• Trip Mate: US travel insurance brand for tour operator, cruise and airline partners. Learn more here.

What you’ll be doing.

Job Summary:

This position is responsible for analyzing and processing insurance claims to determine the extent of the insurance carrier’s 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. Weekends may be required. This position reports to the Claims Supervisor.

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.?

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?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.?

Required / Desired Knowledge, Experiences and Skills:

• Exceptional communication, problem-solving, and organizational skills.?

• Strong reading, writing, comprehension, and proofreading skills.?

• Knowledge of standard concepts, practices, regulations, and laws within insurance field preferred.??

• Bilingual English/Spanish language fluency – verbal, reading, and writing skills, is a plus.?

• Previous claims and customer service experience are highly preferred.

Education/Certifications:

Requirements:

• High School Diploma or Equivalent (GED) required.

Travel Requirements:

• None

Where you’ll be doing it.

This is a hybrid role based out of our _ office. As a hybrid role, you will be working onsite 2-3 days a week and working from home 2-3 days a week.

When you’ll be doing it.

While there is some flexibility in the hours, this position will be Monday-Friday during regular business hours (approximately 8:00am-5:00pm). Occasional overtime may be required according to business need.

Apply today to begin your next chapter.

Don’t meet every single requirement? At Generali Global Assistance, we are dedicated to building a diverse, inclusive and enriching workplace, so if you’re excited about this role but your past experience doesn’t align perfectly with every qualification in the job description, we encourage you to apply anyways. You may be just the right candidate for this or other roles.

California Residents - Privacy Notice for California Residents Seeking Employment with Generali Global Assistance is available here: https://us.generaliglobalassistance.com/privacy-notice-for-california-residents-seeking-employment/

The Company is committed to providing equal employment opportunity in all our employment programs and decisions. Discrimination in employment on the basis of any classification protected under federal, state, or local law is a violation of our policy. Equal employment opportunity is provided to all employees and applicants for employment without regard age, race, color, religion, creed, sex, gender identity, gender expression, transgender status, pregnancy, childbirth, medical conditions related to pregnancy or childbirth, sexual orientation, national origin, ancestry, ethnicity, citizenship, genetic information, marital status, military status, HIV/AIDS status, mental or physical disability, use of a guide or support animal because of blindness, deafness, or physical handicap, or any other legally protected basis under applicable federal, state, or local law. This policy applies to all terms and conditions of employment, including, but not limited to, recruitment and hiring, classification, placement, promotion, termination, reductions in force, recall, transfer, leaves of absences, compensation, and training. Any employees with questions or concerns about equal employment opportunities in the workplace are encouraged to bring these issues to the attention of Human Resources. The Company will not allow any form of retaliation against individuals who raise issues of equal employment opportunity. All Company employees are responsible for complying with the Company’s Equal Opportunity Policy. Every employee is to treat all other employees equally and fairly. Violations of this policy may subject an employee to disciplinary action, up to and including termination of employment.