National Account Claims- Senior Associate

Location
Jacksonville, Florida
Salary
Not Specified
Posted
Sep 22, 2016
Closes
Nov 21, 2016
Ref
40651
Job Type
Not Specified
Career Level
Not Specified

Where good people build rewarding careers.

Think that working in the insurance field can't be exciting, rewarding and challenging? Think again. You'll help us reinvent protection and retirement to improve customers' lives. We'll help you make an impact with our training and mentoring offerings. Here, you'll have the opportunity to expand and apply your skills in ways you never thought possible. And you'll have fun doing it. Join a company of individuals with hopes, plans and passions, all using and developing our talents for good, at work and in life.


Job Description

This area provides a single source of service for Claims and Customer Service for the National Account Customers. This Unit monitors phones, quality of claims/calls and turn-around time in order to meet and/or exceed service levels provided by the contracts with the large cases.

This position is responsible for analyzing and adjudicating claims in accordance with policy provisions with minimal guidance from the medical team or leadership team. A claims examiner must have the ability to interpret and apply laws, rules and regulations as well as evaluate claims from initial report to final determination. They must also be able to obtain and utilize sensitive information discreetly and objectively in addition to documenting claim files with notes, evaluations and decision making processes while achieving optimal customer service.

Responsibilities:

  • A Sr. Associate is responsible for analyzing, processing, researching, adjusting and adjudicating claims which will result in a payment or non-payment of a claim with minimal guidance from the medical team or leadership team.
  • Sr. Associates review insurance policies, the claim form and supporting documentation to make sure that all of the information is correct. They determine whether the claims are covered under the policies issued to that policyholder.
  • Sr. Associates assist in identifying, investigating and reporting fraudulent claim activity to our internal fraud unit.
  • Sr. Associates are required to provide the insured with correspondence that is clear, concise and meets state regulations in relation to the decision they made on the claim processed.

Job Qualifications

  • Previous Claims processing experience preferred.
  • Ability to work in a fast paced/deadline driven environment.
  • Ability to work independently or in a team oriented environment.
  • Ability to interpret and apply laws, rules and regulations.
  • Basic policy coverage and insurance regulation knowledge
  • Verbal/written telephone communication skills
  • Attend training sessions as a participant
  • Basic individual claim authorization
  • Ability to prioritize and handle multiple tasks

Good Work. Good Life. Good Hands®.

As a Fortune 100 company and industry leader, we provide a competitive salary – but that's just the beginning. Our Total Rewards package also offers benefits like tuition assistance, medical and dental insurance, as well as a robust pension and 401(k). Plus, you'll have access to a wide variety of programs to help you balance your work and personal life -- including a generous paid time off policy.

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Allstate generally does not sponsor individuals for employment-based visas for this position.

Effective July 1, 2014, under Indiana House Enrolled Act (HEA) 1242, it is against public policy of the State of Indiana and a discriminatory practice for an employer to discriminate against a prospective employee on the basis of status as a veteran by refusing to employ an applicant on the basis that they are a veteran of the armed forces of the United States, a member of the Indiana National Guard or a member of a reserve component.

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It is the policy of Allstate to employ the best qualified individuals available for all jobs without regard to race, color, religion, sex, age, national origin, sexual orientation, gender identity/gender expression, disability, and citizenship status as a veteran with a disability or veteran of the Vietnam Era.