Glatfelter Insurance Group · 2 months ago
Accident and Sickness Claims Representative
York, PA, US
Full-time
Onsite
Entry, Mid Level
2+ years expGlatfelter Insurance Group is a leading managing general agency in the U.S., providing comprehensive insurance solutions. They are seeking an Accident and Sickness Claims Representative responsible for handling claims from first report to conclusion, ensuring customer satisfaction and compliance with company standards.
Financial ServicesInsurance
Responsibilities
Handles and/or monitors registration and coverage verification of claims
Handles and /or directs the investigation, negotiation and disposition of assigned claims within authority limits
Demonstrates proficiency in developing targeted questions to obtain specific information during claim interviews
Independently gathers and verifies information and documentation necessary for claims evaluation
Settles claims promptly and equitably. Obtains releases as needed. (E) Authorizes and/or issues checks within the limits of financial authority
Maintain a diary system for assigned open claims to ensure necessary tasks are addressed in a timely manner
Identifies and reviews potentially serious cases and fraud indicators with A&S Claims Supervisor or A&S Claims Manager
Handles the assignment of independent vendors and assures efficient use of vendors
Interprets policy forms and provides opinion on coverage. Considers positions of all interested parties within intent of policy and program
Issues Reservations of Rights and/or denial letters after approval by A&S Claims Supervisor or A&S Manager
Informs claimant, insured or attorney of denials and justifies denial when applicable
Ensures prompt and proper disposition of claims
Represents GIG through continuous countrywide contact with insured, carriers, agents, claimants, attorneys, vendors, etc
Performs other duties as required by management
Qualification
Required
Secondary school diploma or equivalent
Moderate knowledge of legal process
Moderate ability to read and interpret insurance policies and make appropriate decisions grounded on those interpretations
Moderate knowledge of insurance coverage and procedures
Moderate knowledge of GIG products and services for emergency service organizations
Ability to communicate effectively, both verbally and in writing
Ability to utilize a PC and related departmental software
Must speak clearly and exhibit the ability to reason and impart information to others
Must be flexible, innovative, self-motivated and able to make sound decisions
Emotional stability and maturity are necessary to deal with the pressure of claims handling
Uses analytical ability and independent judgment within guidelines established by management
Objective in identifying claims elements and translating them to equitable settlements
Ability to compose letters explaining complex issues
Must be able to work independently and prioritize daily tasks in order to meet deadlines
Takes the initiative to continue professional development
Demonstrates teamwork and contributes to improvements and the overall success of the assigned team to achieve unit, department and company goals
Must have or obtain appropriate licenses within an aggressive period of time
Preferred
College degree
Associate in Claims designation
Two (2) years experience handling A&S insurance claims, or appropriate transferable concurrent experience in a related field
Benefits
17 paid holidays, (which includes a personal holiday and mental health and wellness day)
A variety of leaves for personal, health, family, and volunteer needs
Tuition reimbursement program for eligible associates
Company
Glatfelter Insurance Group
An Employee Owned company.
501-1000 employees
Funding
Current Stage
Late StageTotal Funding
unknown2018-09-21Acquired
Leadership Team
Larissa Tosch
CIO and Executive Vice President of Client Service Operations
Company data provided by crunchbase