At Guardian, we live our Purpose every day. As champions of wellbeing for ourselves, our communities, and consumers; we focus as a team to turn what's possible into a reality. We believe in your aspirations for purpose, leadership, and achievement in your professional and personal lives. We create experiences for you to grow, enrich your career and your future as a Claims Support Assistant by providing training to help build the core competencies you will need for success.
In the Role, you will be responsible for providing exceptional customer service to our customers through various administrative tasks such as:
New Claim File Set Up
- Creating an electronic claim file within one business day from receipt of a claim notification.
- Utilize strong knowledge of numerous business systems to validate coverage and populate the Cypress Claim System with all applicable documentation.
Mail Management
- Manage mailing of letters and any other outgoing claims work for all three Individual Markets Claims areas. This includes drafting and tracking of electronic communications.
- Review documents for proper authorization prior to mailing.
- Coordinate daily reconciliation of EOB’s – (Explanation of Benefits) benefit checks, and any applicable attachments to ensure accurate mailing to our customers.
Expense & Claim Benefit Payment Processing
- Input of expense payments and administrative claim payments in Cypress, ensuring accuracy and receipt of all applicable tax reporting documentation needed.
- Responsible for generating the key outputs for the following day’s reconciliation
Reporting
- Completion of daily benefit check reporting
- Completion of monthly Reinsurance reporting
- Completion of yearly IRS Tax reporting
Claim File
- Ensuring accurate claim file documentation for information not processed by our vendor.
- Retrieval of claim information submitted via cloud storage and uploading to the claim file.
- Daily review of queues to provide instruction for indexing to our indexing vendor.
- Printing and collating documents from claim/underwriting files for Litigation or additional claim evaluation.
