Claim Representative-TPA Oversight - Military Veterans

Chubb - Claims Representative - TPA Oversight

The TPA Oversight Claims Representative will work within the TPA Oversight Department and cross-functionally with internal business partners to execute operations tasks, including assigning and transferring claims, identifying TPA companies, and routing electronic correspondence. The Claims Representative assists claims handlers and management with day-to-day functions, including but not limited to Medicare data queries, claim closings, and payment issuance. The Claims Representative will be responsible for special assignments that increase departmental efficiency and is expected to support continuous improvement initiatives. The Claims Representative will deliver a superior level of claims processing functions and customer service under limited supervision.

MAJOR DUTIES/RESPONSIBILITIES OF THE JOB:

• Review and research new claims to assist with loss assignments, including initial assignments to handlers and redirection of losses to TPA companies.
• Analyze incoming electronic correspondence and route it to the correct handler and claim file.
• Support TPA Oversight management.
• Assist adjusters with claims handling responsibilities, including drafting of coverage letters, Medicare data queries, and closure of claims.
• Contribute to the TPA Oversight department's efficiency by completing special projects, such as a review of shadow files to ensure resolved claims are closed.
• Ensure direct actions against Chubb are reviewed timely and referred to counsel to protect Chubb's interests.
• Partner with colleagues both within TPA Oversight and in other departments to continually improve quality and innovation.
• Support an environment of continuous improvement by offering ideas and suggestions to enhance the service level provided to customers and improve workflow issues.
• Promptly report service and/or system problems to the supervisor to ensure service levels to customers and business partners are not adversely impacted.

• High School Diploma or GED Equivalent.
• Effective time management and organizational skills, with the ability to handle multiple tasks simultaneously.
• Strong quality customer service skills.
• Excellent verbal and written communication and interpersonal skills.
• Ability to work effectively in a team environment.
• Basic claim investigation skills.
• Ability to meet or exceed established performance standards.
• Ability to work autonomously, using sound judgment to review and assign claims.
• Thorough understanding and knowledge of claims systems.

The pay range for the role is $40,000 to $66,700. The specific offer will depend on an applicant's skills and other factors. This role may also be eligible to participate in a discretionary annual incentive program. Chubb offers a comprehensive benefits package, more details on which can be found on our careers website . The disclosed pay range estimate may be adjusted for the applicable geographic differential for the location in which the position is filled.