Why work with us?
The North American branch of Generali Global Assistance offers a diverse and inclusive work environment while employees work towards making real difference in the lives of our clients. As an Organization, we pride ourselves with offering white glove service while being mindful of corporate responsibility and our environmental footprint.
Employees enjoy a plethora of benefits to include:
- A diverse, inclusive, professional work environment
- Flexible work schedules
- Company match on 401(k)
- Competitive Paid Time Off policy
- Generous Employer contribution for health, dental and vision insurance
- Company paid short term and long term disability insurance
- Paid Maternity and Paternity Leave
- Tuition reimbursement
- Company paid life insurance
- Employee Assistance program
- Wellness programs
- Fun employee and company events
- Discounts on travel insurance
Who are we?
Generali Global Assistance is proudly part of the Europ Assistance Group brand and our products utilize a number of corporate and product brands. The brands for our North American team include the following:
- CSA: US travel insurance brand for retail and lodging partners. Learn more here.
- Generali Global Assistance (GGA): The primary Corporate brand in the United States for our travel insurance, travel assistance, identity and cyber protection, and beneficiary companion products. Learn more here.
- GMMI: the industry standard for global medical cost containment and medical risk management solutions. Learn more here.
- Iris, Powered by Generali: identity and digital protection solution. Learn more here.
- Trip Mate: US travel insurance brand for tour operator, cruise and airline partners. Learn more here.
What you'll be doing.
Coordinates the daily workflow on assigned clients and general interdepartmental tasks. Responsible for conducting investigations, evaluations and disposition of coverage on assigned accounts.
Principal Duties and Responsibilities:
- Provides support to Manager, Claims
- Assists Manager, Claims in identifying and taking action on improved claims processes
- Addressing social media complaints and working directly with marketing
- Assists in managing the responsibilities of the claims leadership team
- Assists Manager, Claims in ensuring daily/monthly LEAN tasks are followed and documented
- Provides daily support to Team of Claims Examiners to resolve on hand claims processing issues
- Serves as a floater to process claims when examiners are out personal or schedule leave
- Identifies claims processing gaps and informs Manager to handle corrective action
- Responsible for the assignment and resolution of Adjustment Requests
- Monitors incoming claims to identify any backlog, communicates with the assigned Claims Examiner and distributes workload to avoid further backlog
- Responsible for sending request to responsible party or parties for resolution of claims aging in any "HOLD" status
- Identifies needs to request additional information in order to adjudicate a claim (e.g. medical records), communicates with Claims Support and Client Services Coordinators to ensure that information is requested
- Runs Daily Reports
- Trains new hires in the operating system and provides continuous support
- Provides re-training to Claims Examiners regarding Non-Conformance Requests
- Responsible for Monthly QA reviews for assigned examiners with direct reporting. Monthly reviews to be turned in on assigned date by Manager/Director
- Handles live claim audits upon request of Manager/Director of claims department to monitor appropriate training for assigned examiners
- Other responsibilities as assigned by Claims Manager and Senior Management
- Prior knowledge and experience in healthcare and insurance field for processing medical claims
- Proficient in assigned clients policies and procedures
- Total comprehension of all types of medical claims billing
- Extended knowledge on network pricing logic in the operating system
- Complete Knowledge of ICD-9/ICD-10 and CPT procedure codes and all other insurance coding methodologies
- Ability to process minimum of 80-100 claims per day
- Ability to process 40-50 claims per day for adjudication
- A minimum of 5 years prior experience in claims processing is preferred
- A minimum of 5 years' experience in a management or supervisory role is preferred
- Excellent interpersonal skills necessary to interact positively with clients, providers, and employees
- Must be able to represent the organization in a professional and knowledgeable manner
- Excellent verbal and written communication skills with ability to manage and prioritize multiple tasks
- Computer skills necessary to work effectively: Windows Microsoft Word, Excel and Power Point
- Ability to work well under pressure in a production oriented environment
- Excellent problem solving skills and capability to troubleshoot the most difficult claim issues
Where you'll be doing it.
This is a hybrid role based out of our Pembroke Pines, FL office. As a hybrid role, you will be working onsite 2-3 days a week and working from home 2-3 days a week.
When you'll be doing it.
While there is some flexibility in the hours, this position will be Monday-Friday during regular business hours (approximately 8:00am-5:00pm). Occasional overtime may be required according to business need.
Apply today to begin your next chapter.
Don't meet every single requirement? At Generali Global Assistance, we are dedicated to building a diverse, inclusive and enriching workplace, so if you're excited about this role but your past experience doesn't align perfectly with every qualification in the job description, we encourage you to apply anyways. You may be just the right candidate for this or other roles.
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The Company is committed to providing equal employment opportunity in all our employment programs and decisions. Discrimination in employment on the basis of any classification protected under federal, state, or local law is a violation of our policy. Equal employment opportunity is provided to all employees and applicants for employment without regard age, race, color, religion, creed, sex, gender identity, gender expression, transgender status, pregnancy, childbirth, medical conditions related to pregnancy or childbirth, sexual orientation, national origin, ancestry, ethnicity, citizenship, genetic information, marital status, military status, HIV/AIDS status, mental or physical disability, use of a guide or support animal because of blindness, deafness, or physical handicap, or any other legally protected basis under applicable federal, state, or local law. This policy applies to all terms and conditions of employment, including, but not limited to, recruitment and hiring, classification, placement, promotion, termination, reductions in force, recall, transfer, leaves of absences, compensation, and training. Any employees with questions or concerns about equal employment opportunities in the workplace are encouraged to bring these issues to the attention of Human Resources. The Company will not allow any form of retaliation against individuals who raise issues of equal employment opportunity. All Company employees are responsible for complying with the Company's Equal Opportunity Policy. Every employee is to treat all other employees equally and fairly. Violations of this policy may subject an employee to disciplinary action, up to and including termination of employment.