Join Team TMLT

This position is responsible for taking initial loss calls and assisting the Claims Department in performing a full range of administrative functions.

In this role, the successful candidate will:

• respond to telephone calls from policyholders reporting claims, gather incident information, prepare initial loss report, and follow set guidelines before releasing task to the supervisor;
• set up Medefense, Cyber, ELPI claim files in the system;
• enter new claims into Oasis;
• open, batch, scan, and electronically index daily incoming mail to appropriate claim staff members;
• verify claim number(s), pricing, and staff member on miscellaneous, legal, and expert invoices;
• maintain adequate Claim Department office supply stock; and
• perform monthly destruction of old data.

Candidate must be able to communicate effectively, both in person and by phone, with other employees and with outside callers. Should be skilled in English usage: spelling, grammar, and punctuation. Applicant should be organized and able to multi-task. Strict attention to detail is a must. Need to be proficient in Microsoft applications such as Word and Excel.

Candidate must have achieved high school graduation or equivalent and have a minimum of one to two years of office experience, preferably in an insurance claim office which included data entry duties.

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This position, in the Accounting Department, is responsible for the timely and accurate processing of billing duties and providing professional, high-level customer service to policyholders, primarily via telephone.

Duties for this position include:

• prepare daily reporting to be used in reconciling, mailing, and tracking customer service standards of batch invoices;
• perform routine audits of printed batch invoices;
• manage invoices and notices of cancellations (NOCs) for assigned territory and prepares supporting documentation as necessary;
• perform daily audits on AR aging and credit balance reports and works with Underwriting department to resolve any outstanding issues;
• prepare and process policyholder refunds for premium, surplus, and Trust Rewards daily;
• review billing after Underwriting entry on all cancellations, reinstatement, cancel/rewrites, and voids to ensure accuracy;
• respond to incoming calls by answering various questions related to, but not limited to, policy information, risk management/continuing medical education (CME) inquiries, and billing and payment information;
• provide customer service online by connecting through chat support to ensure policyholders receive instant responses in real time;
• provide technical support to policyholders by assisting with navigation of the website, enrollment for the members only site, online payments, and auto-draft enrollment, and managing users’ CME site profiles;
• respond to policyholder inquiries, primarily obtained through the Customer Service general email box, by providing payment histories, claims histories, proof of coverage, and other policy correspondence as requested;
• perform outbound courtesy calls to insureds who have received a NOC or those whose payment was returned as a final collection effort and to retain the account;
• develop personal and professional goals and plans to obtain them; and
• pursue a continuous program of self-development.

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A minimum of two to three years of customer service, underwriting, or accounts receivable experience in an insurance or medical environment is preferred. Some college and/or basic insurance classes preferred.

Required knowledge, skills, and abilities include:

• knowledge of basic accounting procedures, general office practices and procedures, telephone techniques;
• skilled in English usage, spelling, grammar, punctuation, and arithmetic;
• highly proficient in Microsoft applications such as Outlook, Word, with moderate to advanced Excel skills;
• proficient in the use of various web-based applications for billing research/payment inquiries;
• able to communicate effectively, both in person and by phone with other employees and with outside callers;
• strong organizational and customer service skills;
• able to perform duties with speed and high degree of accuracy with minimum supervision; and
• able to work with frequent interruptions.

The successful candidate must have achieved high school graduation or equivalent. Some college and/or basic insurance classes preferred. Minimum of two to three years customer service, underwriting, or accounts receivable experience preferably in an insurance or medical environment. OR, any combination of education, training, and experience, which would provide the level of knowledge, skill, and ability required.

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This position, in the Claims Department, is responsible for the investigation and resolution of assigned medical malpractice claims brought against insured physicians within a prescribed geographical territory.

Individual holding this position should possess:

• ability to handle the investigation, evaluation, negotiation, and settlement of liability claims, as well as the supervision of defense counsel on cases with a potentially moderate to severe exposure;
• five years minimum of progressively responsible experience in the property and casualty insurance field handling bodily injury claims (physicians’ liability experience preferred);
• availability for occasional travel, including overnight stays;
• strong analytical skills and effective oral and written communication skills, plus knowledge and understanding of basic professional liability insurance contracts, regulations, and litigation; and
• Bachelor’s degree and Adjuster’s License required.
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If the successful candidate does not possess an Adjuster’s License, they will be required to obtain the license within six months of employment.

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