Job Description

The primary purpose of the job is to investigate, evaluate, negotiate and settle assigned claims by collecting and analyzing data according to policy application and/or contract provisions. Determine whether to accept or deny a claim based on all documentation received. Typical claims include: liability and low complexity coverage issue disputes. This person is also required to attend inbound and outbound calls.

Duties and Responsibilities

  • Utilizing acceptable investigation claims handling and settlement techniques that achieve cost effective and timely closure results by obtaining, reviewing and analyzing documentation, policy provisions and other records. May require additional contact with other parties (i.e. employer, claimants, third parties such as medical providers, auto repair centers, etc.) as deemed necessary
  • Ensure proper follow up on cases to resolve outstanding issues and to ensure timely processing and closure of claim
  • Provide timely service throughout the life of the claim by meeting all service level agreements, initiating timely contact to all appropriate parties, responding to incoming inquires according to company policies, following agreed internal and external processes, policies and procedures to ensure quality and service standards are met. This includes all forms of communications to internal and external parties
  • Maintaining accurate system data and documentation by collecting, recording, analyzing, and summarizing information
  • Ensure that reserves are accurately updated in a timely manner
  • Identify subrogation opportunities and fraud potential and make appropriate referrals
  • Provide mentorship to less tenured examiners


Qualifications

  • Ability to prioritize and multi-task effectively in a fast-paced environment
  • Ability to communicate information clearly and concisely both verbally and in writing
  • Requires proficiency in Desk Management, phone ‘etiquette’, time management and dealing with difficult customers
  • Computer literate; experience with Microsoft Office Products.

All employment decisions shall be made without regard to age, race, creed, color, religion, sex, national origin, ancestry, disability status, veteran status, sexual orientation, gender identity or expression, genetic information, marital status, citizenship status or any other basis as protected by federal, state, or local law.

Job candidates will not be obligated to disclose sealed or expunged records of conviction or arrest as part of the hiring process.

Accenture is committed to providing veteran employment opportunities to our service men and women.

Please read Accenture’s Recruiting and Hiring Statement for more information on how we process your data during the Recruiting and Hiring process.

COVID-19 update:  The safety and well-being of our candidates, our people and their families continues to be a top priority. Until travel restrictions change, interviews will continue to be conducted virtually. 

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