to: Accurately evaluate and process claims based on relevant documentation. Evaluate claim submissions, determine policy benefits, and request additional information as required to finalize claims. Manage inquiries, escalations and pending files on claim decisions.
Provide exceptional customer service by promptly following up and collaborating with internal and external business partners to address concerns and/or questions. Build broad knowledge of the various online systems for claims processing, imaging and policy administration. Maintain appropriate documentation on all claim files and manage caseload in a timely manner while meeting quality standards and SLAs. Research, analyze,
and interpret policy language and state law as it relates to submitted claims. Communicate and collaborate effectively with Adjusters, Supervisors, and Managers to ensure service levels are met daily.
Recognize, prioritize, and escalate service and claims issues according to escalation guidelines. Support an environment of continuous improvement by offering ideas and suggestions to improve workflows and processes. Performs other duties as assigned. Requisition #: 1174tcv57hlu2
developing, maintaining and measuring the quality of the billing and collection process through the design and implementation of best practices, execution of aud the it process, and management reporting of audit results. Responsi Responsibilities the identification of audit process opportunities and developing audit guidelines that ensure financial and operational objectives of the billing and collections department, defining the documentation and support needed to facilitate the audit program, and communicating results to provide performance feedback and continuous improvement.
Reporting Relationships : Reports directly to SVP Billing and Collections Responsibilities: Responsible for
enhancing billing and collection process quality through active measurement of process standards and provides continuous feedback for billing operations management and staff.
Develop a framework for quality assurance discipline to ensure key processes have been identified for both financial and operational impact, forms/template development to match identified best practices, audit schedule, and capacity planning, audit sampling methodology, and management reporting of results. In partnerhsip with billing, operations leads develop standards or best practices that will be measured through a quality assurance audit process aligned to key financial and operational objectives. Capture and
measure audit results including the development and management of audit forms/templates, audit result repository, and audit sample methodology to ensure evidence and process coverage is achieved.
Develop and distribute documentation of audit results that provides staff, direct management, and senior management understanding of performance and corrective action plans for areas of opportunities. Provide collaboration with billing operations leads to understanding their business objectives, strategies, and ongoing challenges and partner to develop and prioritize key initiatives MINIMUM REQUIREMENTS: Strong background in the Insurance Industry Excellent organizational, communication, and interpersonal skills.
Strong information systems understanding and ability to use internal systems as well as Microsoft Office programs Ability to dissect QA data sets, identify root causes/trends Ability to excel independently and in a team environment. DESIRED QUALIFICATIONS: Bachelor's degree in a related field or proven insurance-related experience. Minimum of 5 years experience in an analytical role. Aptitude for learning is required. Chubb offers a competitive compensation package and comprehensive benefits package including life, health and dental, vision, a generous retirement savings plan, disability coverage, stock purchase plan, flexible spending accounts, tuition reimbursement, and business casual dress.
At Chubb, we are committed to equal employment opportunity and compliance with all laws and regulations pertaining to it. Our policy is to provide employment, training, compensation, promotion, and other conditions or opportunities of employment, without regard to race, color, religion, age, interaction, interactionual orientation, transgender, national origin, disability, genetic information, veteran or marital status, or any other characteristic protected by law.
For additional information about Chubb or its services, please visit our website at http: ///careers To be considered an applicant for employment with Chubb, all applicants must go to Chubb's Careers website to apply for the position(s) of interest and complete an online application. If you do not complete the online application, you will not be considered an applicant in accordance with Chubb's policy. Requisition #: 3545136ahf9io63
