Claim Operations Specialist - West Bridgewater, MA

$42,100 - $69,400/Yr

Travelers - West Bridgewater, MA

Full-time - Entry Level

West Bridgewater, MA

Insurance Carriers and Related Activities

About the position

The Claim Operations Specialist position at Travelers is designed for individuals who are passionate about customer service and operational efficiency within the claims department. This role operates under moderate supervision and is pivotal in assisting claim professionals to ensure a seamless experience for customers. The position is hybrid, requiring candidates to live within a commutable distance of the West Bridgewater, MA office. The responsibilities include building strong customer relationships, managing financial transactions, and maintaining accurate business information. The role does not involve managing others but focuses on collaboration with various departments to facilitate timely claims resolution. In this position, you will serve as a customer service representative, addressing inquiries and concerns from customers regarding their claims. This includes triaging calls, providing claim status updates, and ensuring that customers feel supported throughout the claims process. You will also be responsible for documenting claim files, processing payments, and managing incoming and outgoing mail. Your attention to detail will be crucial as you prepare and review reports, ensuring that all data is accurate and up-to-date. Additionally, you will assist with financial controls and assessments, ensuring compliance with established standards. This may involve performing reconciliations and identifying discrepancies in financial data. The role requires a proactive approach to problem-solving and the ability to communicate effectively with both customers and internal teams. Overall, the Claim Operations Specialist plays a vital role in upholding Travelers' commitment to customer service excellence and operational integrity.

Responsibilities

• Serve as a customer service representative for the claim department by addressing customer questions and concerns.
• Triage and route callers to the appropriate department.
• Document claim files, including notes and diaries, and request reports and records.
• Review medical bills, mail, and wage statements.
• Print and prepare claim documents for legal and medical reviews.
• Report and assign claims, transitioning closed files to and from off-site storage.
• Receive, sort, scan, and upload incoming mail, and process outgoing mail.
• Order, receive, and distribute supplies and/or equipment.
• Process and issue claim payments, including outside vendor invoices and medical processing fees.
• Document returned checks, voided checks, and credits, ensuring timeliness and accuracy of all check processing.
• Prepare, generate, and review reports using effective technology.
• Update data discrepancies identified in reports and systems.
• Prepare operational reports for claim professionals and managers.
• Perform underlying controls and communicate findings regarding financial standards.
• Assess the reasonableness of data and identify discrepancies, including reconciliations.

Requirements

• High School Diploma or GED required.
• 1 year of service-related work experience OR Bachelor's Degree required.
• Experience utilizing computer technology such as Microsoft Office, e-mail, Web-enabled applications, and database software.
• Ability to analyze and compare information to understand issues and explore alternative solutions.
• Ability to remain energized and focused in the face of ambiguity, change, or strenuous demands.
• Strong verbal and written communication skills.
• Ability to exercise sound judgment and make decisions.
• Ability to seek out, build, foster, and maintain productive working relationships.

Nice-to-haves

• Experience in the insurance industry.
• Familiarity with claims processing and financial transactions.

Benefits

• Health Insurance coverage from the first day of employment for employees and their eligible family members.
• 401(k) matching contributions dollar-for-dollar up to the first 5% of eligible pay, subject to an annual maximum.
• Pension Plan that is 100% funded by Travelers.
• Minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.
• Access to a wellness program that includes tools, discounts, and resources for wellness goals.
• Mental health program providing access to free professional counseling services and health coaching.
• Matching Gift and Volunteer Rewards program to encourage community involvement.