Claims Service Representative – Employee Health and Benefit – R_283128-6153

This job was posted by https://illinoisjoblink.illinois.gov : For more
information, please see:
https://illinoisjoblink.illinois.gov/jobs/12216958 About Marsh
McLennan Agency Midwest

Marsh McLennan Agencys Midwest Region is a full-service brokerage
providing business insurance, employee benefits, private client
insurance, and retirement services to businesses and individuals across
the country. MMA Midwest is consistently recognized as a top workplace,
attracting and retaining its insurance talent by rewarding expertise and
investing in career development. Colleagues enjoy an award-winning
culture that fosters a highly productive and results-driven working
environment.

The Claims Service Representative plays a key role in supporting the
Claims team by assisting with the coordination of communication between
clients, members, service teams, providers and insurance carriers. They
respond timely to questions asked by clients, members and internal
teams, advising

clients/members on coverage questions and gathering information and
documents needed to resolve claim issues to conclusion. Additionally,
the Claims Service Representative supports the teams Claims
Consultants with status

updates and reviews.

Claims

– Processes claim information from the client or member, completes
HIPAA verification and inputs claim information into the system
– Instructs member on gathering proper claim information needed for
claim reporting and inputs claims into the system
– Completes intake process to follow claim progress as needed,
assigning to other team members appropriately
– Updates system claim notes, open/closure activities and monitors and
maintains One Note status notes.
– Maintains a concern for timeliness and completeness when interacting
with customers, agency teams and staff to minimize potential for
error and omission claims
– Updates clients, members, and service teams regarding claim status
– Communicates claims concerns or potential problems to appropriate
Claims Consultant or Claims Manager
– Completes monthly projects on time
– Completes client value reports quarterly or annually
– Assists in developing training and updating of internal claim
procedures and updating client folders.
– Addresses and resolves client claim questions/problems
– Identifies and prioritizes time sensitive claim inquiries/issues and
reports to Claims Consultant as appropriate

Execution of Client Service

– Supports Claims team members and other internal department members
to flawlessly execute MMA Midwests Claim strategy for each client,
designed to create measurable value and efficiencies in their
businesses
– Processes changes, as needed or requested by the client, checking
for consistency and documenting in the appropriate system
– Builds personalized client relationships through demonstrated
understanding of the service plan and multiple channels of
communication such as phone, email and in-person meetings
– Leverages insurance knowledge and communication skills to explain
coverage terms and claims strategy.
– Works with internal departments to ensure cohesiveness and
timeliness of service execution
– Manages time effectively to prioritize workload, client service
requests and service parameters on business processes

Data and Process Integrity

– Maintains accurate and complete claim data in Applied systems
including new claim submissions, activities, attachment, or anything
in regard to claims
– Consistently achieves data integrity and meets activity timeliness,
quality metrics and goals
– Follows processes and procedures in servicing workflow, maintaining
appropriate and clear documentation of client and vendor
conversations, taking appropriate action, and following up as
requested
– Completes monthly re orts; to include Client Value Reports and any
specific reports as requested by client or Claims Consultant
– Completes reconciliation of claims payments at frequency requested
by auditors or clients
– Answers hotline calls timely and sends follow up email to member
recapping phone call details.
– Utilizes internal resources for identified processes to ensure
efficiency and consistency in execution

Peer Relationships

– Provides feedback and shares information at team meetings
– Participates in ongoing scheduled meetings with Claims Team to
discuss accounts, renewals, service needs, service platform, etc.
– Develops successful and effective working relationships with
Producers, Account Executives, Account Managers, service team
members, managers, carriers, and members of other departments
– Communicates effectively with Claims Team members and provides
timely and complete information to allow them to effectively manage
service execution

A Great Place to Work. A Great Place to Perk.

Recognized for workplace culture by the likes of Fortune Magazine, The
Chicago Tribune and more, our colleagues enjoy an environment that
fosters creativity as well as individual and organizational growth. A
small sampling of the benefits