Accenture Consultant

Auto  Vendor Services Examiner Job Summary

 

Responsible for researching/reviewing Personal and Commercial Lines auto claims received from Westfield’s third party administrators to: determine coverage, provide coverage and policy information, set up claims, issue payments, research inquiries, provide support, issue denial letters if appropriate, and make decisions to resolve matters with insureds, claimants, and internal and external business partners.  Delivers quality customer service on auto vendor programs in a high volume, low complexity work environment.

 

 

Essential Functions (primary functions and/or reasons the job exists in order of importance)

1. overage Determination/Claim Setup – Confirms and provides appropriate coverage and policyholder basic contract information to Westfield’s third-party administrators.  Performs new claim set up and issues claim payments on failed integration claims.  Maintains a strong knowledge of Personal and Commercial Lines coverage exceptions in all states in which Westfield writes business.  Sends coverage denial letters if appropriate.
2. Customer Service - Ensures customer service excellence.  Responsible for the customer and agent experience associated with auto vendor programs.  Provides information, answers questions, researches situations, makes decisions and/or solves problems to provide effective customer service to customers, agents, claimants, and internal and external business partners.
3. Quality Claim Management - Researches and manages claim activities.  Maintains a strong working knowledge of the claim system, mainframe policy system, and auto rental management systems.
4. Vendor Program Support – Provides support to auto vendor programs and serves as auto program liaison on claims.
5. Communication - Maintains effective and ongoing communications with insureds, claimants, agents, attorneys, other insurance companies, representatives, vendors, and company personnel as appropriate.  Prepares various claim-related correspondence to internal and external customers.
6. Reporting - Tracks and reports auto claims process and billing trends to Auto and ACS Leader.
7. Training - Provides auto vendor program training to other claims professionals so they can provide backup support as needed.
8. Travel - Travels occasionally in order to participate in special assignments, training, and/or travel between office locations.

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Desired Qualifications/Experience/Certification/Education (in order of importance)

 

 

1. 1 or more year’s equivalent claims adjusting or insurance industry-related experience.
2. Experience working with customers and demonstrated ability to provide strong and consistent customer service.
3. Experience with Microsoft Windows, Outlook, and Excel or transferable software packages.
4. Ability to learn and understand basic data entry, 5.3 system, and insurance and claims operations.
5. Ability to work independently, prioritize work, solve problems, and manage time.
6. Strong organizational and negotiation skills; ability to handle conflict.
7. Claims experience with some knowledge of mainframe and/or ClaimCenter.
8. High School Diploma, General Education Diploma (G.E.D.) or commensurate experience.
9. Valid driver’s license and a driving record that conforms to company standards.

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Physical Requirements (specific to the role)                                            

 

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. 

• Ability to work effectively in an office environment for 40+ hours per week (including sitting, standing, and working on a computer for extended periods of time).
• Ability to communicate effectively in a collaborative work environment utilizing various technologies such as:  telephone, computer, web, voice, teleconferencing, e-mail, etc.
• Ability to travel as required.

 

 

This job description describes the general nature and level of work performed in this role. It is not intended to be an exhaustive list of all duties, skills, responsibilities, knowledge, etc. These may be subject to change and additional functions may be assigned as needed by management.

 

We are an equal opportunity employer/minority/female/disability/protected veteran.