Claim Resolution Specialist

Combined Insurance a Chubb Company is seeking a Bilingual Claims Resolution Specialist to join our fast-paced high energy growing are proud of our tradition of success in the insurance industry of over 100 years. Come join our team of hard-working talented professionals!

Job Summary

The Bilingual Claims Resolution Specialist will drive business by processing entry-level claims including payment and status updates. Additionally the role is responsible for addressing and resolving escalated customer inquiries that arise via phone or email. The role will perform assigned tasks within the Claims department in accordance with established procedures and guidelines while developing the skills and knowledge required for adjudicating more complex claims. This role is the final tier for Policy Holder Escalations and is a phone-centric role.

Responsibilities

• Develop the ability to work effectively with the policyholders providing accurate and timely information as required by our business standards
• Reviews processes and accurately pays claims on supplemental coverage according to Company procedures policies and appropriate state regulations
• Request additional information from policyholders providers and others as necessary to finalize claims
• Manage pending files
• Ability to handle/address customer phone/email inquiries with a customer-centric approach. Handling of escalated
• Create claim related correspondence
• Provide customer service to internal and external customers by answering questions both in writing and by phone.
• Meet department standards for time service and quality
• Build customer and product knowledge to manage claim / call handling policies procedures processes and tools as well as Claims competencies
• Understand organizational objectives support process improvements and provides feedback to leadership
• Perform other duties as assigned

Competencies

• Problem Solving/Critical Thinking:Takes an organized and logical approach to thinking through problems and complex complexity by breaking down issues into manageable beyond the obvious to get at root insight into problems issues and situation.
• Continuous Learning:Demonstrates a desire and capacity to expand expertise develop new skills and grow and takes ownership of opportunities to learn acquire new knowledge and deepen technical advantage of formal and informal developmental on challenging work assignments that lead to professional growth
• Initiative:Willingly does more than is required or expected in the objectives on time with minimal and willing to go the extra mile in terms of time and effort. Is self-motivated and seizes opportunities to make a difference.
• Adaptability:Ability to re-direct personal efforts in response to changing receptive to new ideas and new ways of doing prioritizes according to competing demands and shifting navigate through uncertainty and knows when to change course
• Results Orientation:Effectively executes on plans drives for results and takes accountability for and does not give up easily in challenging situations. Recognizes and capitalizes on full accountability for achieving (or failing to achieve) desired results
• Values Orientation:Upholds and models Chubb values and always does the right thing for the company colleagues and direct truthful and trusted by as a team ethically and maintains a high level of professional high collaboration within own team and across the company; constantly acts and thinks OneChubb

Skills

• Ability to work in a fast-paced environment
• Ability to manage competing priorities and problem-solve
• Strong organizational skills with attention to detail
• Excellent written and verbal communication skills
• Quality and customer centric orientation
• Analytical with good decision- making skills
• Medical terminology knowledge preferred
• Insurance experience preferred
• Proficient in MS Office Suite
• Bilingual (English/Spanish) is a requirement written read interpret and translate.

Educationand Experience

• 0-1 yrs. experience in claims preferred
• High school diploma required
• 5 yrs. Experience in call center environment preferred