Claims Adjuster
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Job Description
Claims Adjuster resolving complex travel medical claims for a global travel insurance company. Adjudicating benefits, processing invoices, detecting fraud, and supporting travelers worldwide.
Responsibilities:
- Investigate, evaluate, and resolve travel medical claims end-to-end
- Adjudicate benefits per policy terms and statutory requirements
- Process invoices through cost-containment networks
- Maintain clear, timely updates to customers, providers, and partners on claim status
- Document thoroughly in the claims system and ensure complete, high-quality files
- Assess the need for medical management and escalate appropriately
- Process bills in accordance with statutory requirements and internal controls
- Identify potential fraud/waste/abuse and collaborate with investigative team
- Deliver excellent written and verbal customer communication throughout the claim lifecycle
- Perform additional responsibilities as needed to support the team and customers
- Set clear, relevant goals and consistently surpass them
- Prioritize work that moves the needle for travelers and the business
- Build strong relationships with customers, providers, and partners
Requirements:
- Proven experience handling travel insurance claims, including complex domestic and international cases
- Current (or ability to obtain) state adjuster licensing
- Strength in writing, negotiation, communication, organization, reporting, data gathering, reserving, brainstorming, and researching
- Comfort working with data, forms, spreadsheets, and policy wordings
- Must hold (or be eligible to obtain) state adjuster licenses for adjudicating travel insurance claims
- Adhere to state insurance regulations
- Maintain continuing-education requirements tied to state licenses
- Startup or high-growth environment experience is a bonus
- Additional language skills are a bonus
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