TPA Service Specialist TravelGuard
About The Position
Zurich North America Claims acknowledges that work-life balance and flexibility are a priority. The ZNA Claims hybrid work model emphasizes flexibility, allowing employees to conduct individual work in their preferred location while facilitating in-person connections and collaborative activities. Occasional in-office attendance should be expected. The candidate will collaborate with Zurich CoverMore (Travel Guard/Travelex) partners regarding the oversight of TPAs that adjudicate claims on travel policies. Additional involvement with assistance providers for review/approvals on in-flight cases where a traveler needs medical assistance/medical evacuation. This role will involve auditing TPA claim handling, ensuring service level agreements are met, reviewing claims above TPA authority for approval, and reviewing appeals and regulatory complaints. Collaboration with TravelGuard partners is a critical responsibility.
Requirements
- Bachelor’s Degree and 5 or more years of experience in the Operations area within the Insurance industry OR High School Diploma or Equivalent and 7 or more years of experience in the Operations area within the Insurance industry
- Experience in insurance industry operations and systems
- Experience with Microsoft Office
Nice To Haves
- Travel claims experience
- Strong verbal and written communication skills
Responsibilities
- Manages resolution of service issues between customers, brokers, business units and support service areas.
- Drives the due diligence, technical guidance and contract development on new Third Party Administrators.
- Ensures Business Unit Third Party Administrators policies and practices are aligned with the Global Claims Policy and tracks and manages audit improvement actions assigned.
- Manages Third Party Administrators performance issues.
- Drives continuous improvement in customer experience and cost savings.
- Manages Third Party Administrators audit and oversight processes and procedures in partnership with Business Unit Claims function.
- Partners with the Business Unit to provide corporate governance, assistance and control and mitigate regulatory matter.
- Provides required support to Business Unit Claims operation to ensure compliance with Third Party Administrators policy and processes.
Benefits
- Competitive pay
- Comprehensive benefits for employees and their families
- Short-term incentive bonus eligibility
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
