Description
WHO WE ARE
Relation Insurance is a leading, innovative company with a strong commitment to excellence and a passion for delivering cutting-edge solutions to our clients. As a key player in the insurance market, we pride ourselves on our dynamic culture, collaborative environment, and continuous drive for success. With a rich history and a bright future ahead, we are looking for exceptional individuals to join our team and contribute to our ongoing growth and success.
WHAT WE'RE LOOKING FOR
The Claims Specialist manages the claims process for the Company’s client base by working in partnership with claims operation and the client. The individual in this position ensures client retention goals are met by responding promptly to requests from clients, insureds, carriers, and Service team members.
A GLIMPSE INTO YOUR DAY
- Serves as client advocate and primary claims contact for assigned accounts.
- Liaisons between clients, insureds, brokers, and carriers for claims.
- Develops professional business relationships with all clients, brokers and carrier partners and demonstrates a clear understanding of the client’s core business.
- Manages client expectations, service commitments, and anticipates needs of the clients.
- Answers client correspondence related to claims in a timely manner and provides benefit interpretation and guidance.
- Quickly identifies and resolves and processes basic, complex, and expert level claims service issues using independent judgement and discretion.
- Reviews and responds to appeals, ensuring to meet response deadlines.
- Prepares reports as requested by collecting, analyzing, and summarizing information.
- Maintains claims files; responsible for accurately and consistently documenting files and properly communicating in accordance with company workflows, procedures, and best practices.
- Ensures legal compliance by following company policies, procedures, and guidelines, as well as state and federal insurance regulations.
- Stays up to date and ensures compliance with relevant laws and claims regulations.
- Maintains a high degree of accuracy in all aspects of position.
- Recommends and implements process improvements as needed.
- Performs other duties and special projects as assigned.
Requirements
WHAT SUCCESS LOOKS LIKE IN THIS ROLE
- High School Diploma or equivalent. Bachelor's degree preferred.
- 3-5 years’ experience in a claim processor role with a demonstrated track record of achieving exceptional quality assurance standards.
- Licensure as required by any applicable law, regulation and/or regulatory authority.
- May be required to maintain an active driver’s license.
- Excellent interpersonal and communications skills (written and oral) are required to maintain effective relationships with clients, co-workers, carriers, vendors, and others.
- Must be able to understand written and oral communications and interpret information written within policies.
- Advanced knowledge of claim adjudication standards and procedures, including application of plan designs and administrative services agreements.
- Outstanding analytical, investigative and project management skills. Proficient in using Microsoft Suite Office.
- Mastery of knowledge in the applicable lines of coverage, including any laws or regulations that may apply.
WHY CHOOSE RELATION?
- Competitive pay.
- A safe and healthy work environment provided by our robust benefit program including family health and wellness programs, 401K, employee assistance programs, paid time off, paid holidays and more.
- Career advancement and development opportunities.
- Paid training and continuing education to obtain/maintain your insurance license.
Note: The above is not all encompassing of the full position description.
Relation Insurance Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.
The wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the position may be filled. At Relation, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is presented within this posting.
You may also be eligible to participate in a discretionary annual incentive program, subject to the rules governing the program, whereby an award, if any, depends on various factors, including, without limitation, individual and organizational performance.