Customer Resolution Specialist - Accident & Health Insurance - Milwaukee, WI (Hybrid or Remote)

Allstate Insurance
dental insurance, paid time off, tuition assistance, 401(k)
United States, Wisconsin, Milwaukee
Nov 21, 2023
The world isn't standing still, and neither is Allstate. We're moving quickly, looking across our businesses and brands and taking bold steps to better serve customers' evolving needs. That's why now is an exciting time to join our team. You'll have opportunities to take risks, challenge the status quo and shape the future for the greater good. You'll do all this in an environment of excellence and the highest ethical standards - a place where values such as integrity, inclusive diversity and accountability are paramount. We empower every employee to lead, drive change and give back where they work and live. Our people are our greatest strength, and we work as one team in service of our customers and communities. Everything we do at Allstate is driven by a shared purpose: to protect people from life's uncertainties so they can realize their hopes and dreams. For more than 89 years we've thrived by staying a step ahead of whatever's coming next - to give customers peace of mind no matter what changes they face. We acted with conviction to advocate for seat belts, air bags and graduated driving laws. We help give survivors of domestic violence a voice through financial empowerment. We've been an industry leader in pricing sophistication, telematics, digital photo claims and, more recently, device and identity protection. We are the Good Hands. We don't follow the trends. We set them. Job Summary: The Accident & Health Operations Customer Resolution Support Specialist is responsiblefor researching and responding to formal complaints on behalf of all areas of National General Accident and Health Company. Key Responsibilities: * Coordinates, researches, and makes recommendations/decisions on resolutions to formal complaints received from various sources, including the Attorney Offices, Provider Offices, Members, Sales Agents and other sources * Coordinates, researches, and makes decisions regarding premium refunds based on requests from members * Creates and sends specific written responses regarding any decisions that are made within the state-required timeframes * Logs complaints appropriately to be reported back to the state and internal management as required * Prepares complaints to be presented at Grievance Panel by the Grievance Panel Coordinator * Prepares rescission cases to be presented at Rescission Panel including any correspondence that needs to be sent out to the customer * Provides input to update or create workflows, processes, and tools used by the team such as the database and letter templates * Communicates decisions to Third Party Administrators to correct claims, update eligibility, or any other action needed to complete a complaint * Provides support to complete Insurance Department and Better Business Bureau Complaints * Acts as a subject matter expert in all aspects of all Accident and Health products including applications, claims, billing, and administrative rules Supervisory Responsibilities: This job does not have supervisory duties. Education and Experience: * High School Diploma or GED (Preferred) * 0-2 years experience (Preferred) * In lieu of the above education requirements, an equivalent combination of education and experience may be considered. Certificates, Licenses, Registrations: * No Certification, License or Registration is required for the job. Functional Skills: * Proficient in Microsoft Office (Word, Excel, Outlook, PowerPoint) * Must possess effective verbal and written communication skills * Must perform well in high-energy, dynamic and team-oriented environments * Ability to problem solve and make decisions independently based on contract language and documented processes * Effective organization and time management skills with the ability to work under pressure and adhere to departmental and state mandated deadlines * High degree of independence, dependability, and motivation * Outstanding customer service skills, including the ability to diffuse upset customers by writing detailed letters that explain any decisions that have been made in regard to the complaint submitted * Ability to make sound decisions that maintain compliance with state and company guidelines * Excellent interpersonal skills with the ability to establish working relationships with individuals at varying levels within the organization Notes: The preceding description is not designed to be a complete list of all duties and responsibilities. May be required to perform other related duties as assigned. Regular, predictable attendance is an essential function of this job. Compensation offered for this role is$42,500.00-$78,875.00 per yearand is based on experience and qualifications. The candidate(s) offered this position will be required to submit to a background investigation, which includes a drug screen. Good Work. Good Life. Good Hands. As a Fortune 100 company and industry leader, we provide a competitive salary - but that's just the beginning. Our Total Rewards package also offers benefits like tuition assistance, medical and dental insurance, as well as a robust pension and 401(k). Plus, you'll have access to a wide variety of programs to help you balance your work and personal life -- including a generous paid time off policy. Learn more about life at Allstate. Connect with us on , , and or watch a . #LI-KS1 Allstate generally does not sponsor individuals for employment-based visas for this position. Effective July 1, 2014, under Indiana House Enrolled Act (HEA) 1242, it is against public policy of the State of Indiana and a discriminatory practice for an employer to discriminate against a prospective employee on the basis of status as a veteran by refusing to employ an applicant on the basis that they are a veteran of the armed forces of the United States, a member of the Indiana National Guard or a member of a reserve component. For jobs in San Francisco, please click "" for information regarding the San Francisco Fair Chance Ordinance. For jobs in Los Angeles, please click "" for information regarding the Los Angeles Fair Chance Initiative for Hiring Ordinance. To view the "EEO is the Law" poster click "here". This poster provides information concerning the laws and procedures for filing complaints of violations of the laws with the Office of Federal Contract Compliance Programs To view the FMLA poster, click "here". 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