Claims Representative

[{{ $ctrl._job.status.name | translate}}] Claims Representative
Marriott International HQ

Posted

Job description

Marriott International is the world’s largest hotel company, with more brands, more hotels and more opportunities for associates to grow and succeed.  We believe a great career is a journey of discovery and exploration.  So, we ask, where will your journey take you?

Job Summary

Responsible for the administration and disposition of medical only (MO) workers compensation (WC) claims.  Caseload will be exclusively WC claims and responsibility is limited to non-litigated medical only and disability claims of limited duration. Claims involving continuous trauma or occupational disease are excluded from assignment. Work is generally varied and administrative or project oriented. Generally complete tasks under direction of Claims Unit Manager.
 

Follow all company and safety and security policies and procedures. Maintain confidentiality of proprietary information and protect company assets. Speak with others using clear and professional language. Prepare and review written documents accurately and completely. Develop and maintain positive working relationships with others, support team to reach common goals, and listen and respond appropriately to the concerns of other employees and outside agency personnel.  

                   
CRITICAL TASKS
 

Policies and Procedures

  • Maintain confidentiality of proprietary materials and information.
  • Protect the privacy and security of customers and co-workers.
  • Follow company and department policies and procedures.
  • Research questions and problems; refer complex issues to supervisor.
  • Protect company tools, equipment, machines, or other assets in accordance with company policies and procedures.

Customer Relations

  • Address customers' service needs in a professional, positive, and timely manner.
  • Actively listen and respond positively to customers’ questions, concerns, and requests of others.
  • Assist other employees to ensure proper project and program coverage and service.
Communication
  • As appropriate, contact injured associates, unit managers or supervisors, and/or medical providers to confirm causal relationship or injury/condition to compensable occurrence.
  • Answer routine questions from operations on case status (i.e. RTW status, transitional duty updates, medical updates).
  • Discuss work topics, activities, or problems with co-workers, supervisors, or managers using proper discretion.
  • Answer telephones using appropriate etiquette including answering the phone within 3 rings, answering with a smile in one's voice, using the callers' name, transferring calls to appropriate person/department, requesting permission before placing the caller on hold, taking and relaying messages, and allowing the caller to end the call.
  • Speak to customers and co-workers using clear, appropriate and professional language.
  • Prepare and review written documents (e.g., daily logs, business letters, memoranda, reports), including proofreading and editing written information to ensure accuracy and completeness.
  • Talk with and listen to other employees to effectively exchange information.
  • Compose routine correspondence or documents, such as form letters.

Working with Others

  • Treat all employees and customers with dignity and respect.
  • Develop and maintain positive and productive working relationships with other employees and departments.
  • Partner with and assist others to promote an environment of teamwork and achieve common goals.
  • Actively listen to and consider the concerns of other employees, responding appropriately and effectively.

Planning and Organizing

  • Handle between approximately 150claims on assignment; however, acceptable caseloads vary based on jurisdiction mix, incoming volume and administrative requirements.
  • Upon supervisory (or designee’s) written approval, calculate and pay temporary total, temporary partial, or permanent partial disability benefits per statutory requirements.
  • Secure medical information and reports, provide for fee schedule or other appropriate bill review, and process for payment in accord with Marriott policies and procedures.
  • Coordinate medical management aspects of file handling with the Nurse CARE Manager and Nurse Review Specialist.
  • Prepare case overview(s) for department’s Service Call Program.
  • Depending on case volume, perform other assigned tasks as assigned by unit supervisor, operations manager, or director.
  • Maintain targeted closure ratio.
 
Physical Tasks
  • Enter and locate work-related information using computers and/or other methods.
Quality Assurance
  • Comply with quality assurance expectations and standards.
Documentation/Reporting
  • Maintain computer- and paper-based filing and organization systems for records, reports, documents, etc.
  • Maintain all files on computer diary for supervisor (or designee’s) review.
  • Conduct periodic file reviews for identification of aged cases (open 90 days or more) for inactivity and closure consideration.
  • Prepare, review for accuracy and completeness, and file appropriate reports or forms per jurisdiction requirements.
Computers/Software
  • Transmit information or documents using a computer.
  • Enter and retrieve information contained in computer databases using standard computer technology (e.g., a keyboard and mouse) to update records, files, reservation and answer inquiries from customers.
  • Prepare letters, memos, and other documents using word processing, spreadsheet, database, or presentation software.
Office Equipment
  • Transmit information or documents using mail, scanner, or facsimile machine.
  • Operate standard office equipment other than computers such as telephone, typewriter, scanner, fax, photocopier, calculator, and electronic peripherals.
 
CRITICAL COMPETENCIES
 
Personal Attributes
  • Integrity
  • Dependability
  • Positive Demeanor
  • Presentation
  • Initiative
  • Stress Tolerance
  • Adaptability/Flexibility
Interpersonal Skills
  • Team Work
  • Customer Service Orientation
  • Diversity Relations
Communications
  • Telephone Etiquette Skills
  • English Language Proficiency
  • Communication
  • Writing
  • Listening
  • Applied Reading
Organization
  • Detail Orientation
  • Multi-Tasking
  • Time Management
  • Planning and Organizing
Analytical Skills
  • Computer Skills
  • Learning
General Administration
  • Typing
  • Filing
Computer Software
  • Microsoft Office
 
 
 
PREFERRED QUALIFICATIONS
Education
College degree preferred

Related Work Experience

At least 2 years of related experience

Supervisory Experience

No supervisory experience is required
 
 
Marriott International is an equal opportunity employer committed to hiring a diverse workforce and sustaining an inclusive culture. Marriott International does not discriminate on the basis of disability, veteran status or any other basis protected under federal, state or local laws.

Requirements

See description

Job type
Fulltime job
Location
Bethesda, MD, United States
Department
Administration & General
Starting in
As soon as possible

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