Marsh McLennan Agency's 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 team's 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 Midwest's 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 reports; 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 our colleagues enjoy include:
Medical, dental, vision, 401K benefits and more
The flexibility to work at home or an office
A paid day off to volunteer and company-organized volunteer events
Up to $1,000 per year in matching charitable donations
Up to $750 per year in wellness rewards
A company-wide mentality that you can never appreciate your co-workers too much
Who You Are is Who We Are
MMA Midwest has created an award-winning culture largely due to meeting our colleagues where they are, celebrating their differences and building an inclusive environment. We challenge ourselves to create a workplace where our colleagues feel not only welcomed, but feel they belong; where we not only embrace diverse perspectives and opinions but seek them out; and where we ask not how a colleague fits our culture, but what they add to it.
Marsh McLennan and its affiliates are EOEMinority/Female/Disability/Vet/SexualOrientation/Gender Identity employers.