Claims Processing Auditor I
Under immediate supervision, provides a full range of support to the Lead Claims Processing Auditor and Claims Processing Manager. Expedites the processing and payment of all claims. Must have the ability to read, analyze, and interpret procedure documents.
ProAg Core Values:
• Ensures Accountability. Takes personal responsibility and ownership of successes and challenges.
• Communicates Effectively. Actively seeks out and communicates with key stakeholders in all situations.
• Resourcefulness. Determines how to meet customer and employee needs and finds the resources to get it done.
• Customer Focus. Every interaction is a customer and is handled with empathy and seriousness.
• Instills Trust. Makes intentions clear and meets shared challenges together, showing respect for the relationship and the team.
• Monitor claims through auditing and data entry activities.
• Ensure claims are adequately documented in processing system.
• Track claims for timeliness.
• Work closely with Underwriting to ensure any changes required to claims are made in the system prior to payment.
• Process loss claims for payment.
• Attend assigned trainings as needed.
• Communicate information clearly and effectively to Adjuster, Supervisor, and Agent.
• Work closely with Underwriting, Compliance, and Accounting departments.
• Provide support to other regions as needed through cross-training activities.
• Responsible for adhering to the expectations of the ProAg policyholder touchpoints, including but not limited to:
o Clear, concise, accurate and timely communication with the policyholder from beginning to end of the claims processes.
• Be equipped and prepared to perform loss adjustment which includes informing and educating the policyholder as providing a timely and accurate paperwork.
• Preform other relevant duties as assigned.
• Follow work plans, established timelines, and predefined goals for assigned work.
• Meet commitments on deadlines.
• Develop strong customer focus and high service level relationship with clients.
• Perform work thoroughly in a cost-efficient manner and at a high productivity level.
• Utilize company resources effectively.
Business Controls and Policies
• Comply with all corporate policies and procedures.
• Take all reasonable steps to safeguard company assets against waste, loss, unauthorized use, and misappropriation.
• Report breakdown in controls to a supervisor or manager.
• No people management responsibility.
Minimum High School or GED
Preferred: Up to two years of relevant and progressive professional experience
Other Skills and Competencies
• Must have the ability to read, analyze, and interpret procedure documents
• Ability to conduct daily duties in a professional appearance and manner
• Sound analytical skills with an attention to detail, as well as problem-solving aptitude
• Ability to be given direction once and apply logic in future tasks
• Must be able to effectively and efficiently multi-task, set and shift priorities, and adapt to change
• Know when to ask questions or when to resolve on own
• Efficient time management skills
• Excellent organizational skills
• Ability to handle sensitive and/or confidential material strictly in accordance with company policy, Risk Management Agency (RMA) guidelines, etc.
• Demonstrate flexibility and a willingness to learn
• Possess and have ability to apply knowledge of principles, practices, and procedures
• Solid written and verbal communication skills with an emphasis on confidentiality, tact, and diplomacy to communicate effectively both orally and in writing with employees and customers
• Advanced organizational and analytical skills; demonstrated ability to manage multiple tasks simultaneously
• Knowledgeable of industry changes, legal updates, and technical developments related to applicable area of the Company's business to proactively respond to changing business environment
• Intermediate proficiency and experience using Microsoft Office package (Excel, Access, PowerPoint, Word)
Working Conditions and Physical Demands
• Overtime hours may be required to fulfill job responsibilities
• May be required to stoop, bend, or sit for extended periods of time
• May be required to lift up to 10 pounds
• Dexterity of hands and fingers to operate a computer keyboard, mouse, and other devices
• Close vision and ability to adjust focus; required to read a computer screen
Required: Occasional travel (up to 10% of time)
This document is intended to describe the general nature and level of work being performed, and is not to be construed as an exhaustive list of all responsibilities, duties and skills required for the job.
The Tokio Marine HCC Group of Companies offer a competitive salary and employee benefit package. We are a successful, dynamic organization experiencing rapid growth and are seeking an energetic and confident individual to join our team of professionals. The Tokio Marine HCC Group of Companies are equal-opportunity employers. Please visit www.tokiomarinehcc.com for more information about our companies.
ProAg will consider all requests for reasonable accommodation as outlined in the Employee Handbook. Management may, at its discretion, assign or reassign duties and responsibilities to this job at any time.