Program Specialist - Marriott Claims Services

Job Description

Job Number 23200718
Job Category Administrative
Location Western Casualty Claims Office, 3100 Bristol Street Suite 425, Costa Mesa, California, United States VIEW ON MAP
Schedule Full-Time
Located Remotely? N
Relocation? N
Position Type Management
JOB SUMMARY

• Travel Award of $500 Marriott Gift Card. To be eligible, you must not be currently employed by Marriott International, Inc. or any of its subsidiaries and complete six (6) months in the new position.

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, occupational disease or significant injuries are excluded from assignment. Work is generally varied and administrative or project oriented. Generally complete tasks under direction of supervisor.

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 TASK

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 150-300 claims 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.
• Obtain insurance licensing, where required

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 systems for records, reports, documents, etc.
• Maintain all files on computer diary for supervisor (or designee’s) review

CRITICAL COMPETENCIES

Personal Attributes

• Integrity
• Dependability
• Positive Demeanor
• Presentation
• Initiative
• Stress Tolerance
• Adaptability/Flexibility

Interpersonal Skills

• Teamwork
• Customer Service Orientation
• Diversity Relations

Communications

• Telephone Etiquette Skills
• English Language Proficiency
• Verbal Communication
• Writing
• Listening
• Applied Reading

Organization

• Detail Orientation
• Multi-Tasking
• Time Management
• Planning and organizing

Analytical Skills

• Computer Skills
• Learning

General Administration

• Typing

Computer Software

• Microsoft Office

PEFERRED QUALIFICATIONS

• Education: College degree preferred

The hourly pay range for this position is $19.25 to $32.50 and offers health care benefits, flexible spending accounts, 401(k) plan, accrued paid time off (including sick leave where applicable), life insurance, disability coverage, other life and work wellness benefits and may include incentive compensation. Benefits and incentive compensation may be subject to generally applicable eligibility, waiting period, contribution, and other requirements and conditions.

Marriott International is an equal opportunity employer. We believe in hiring a diverse workforce and sustaining an inclusive, people-first culture. We are committed to non-discrimination on any protected basis, such as disability and veteran status, or any other basis covered under applicable law. Marriott International considers for employment qualified applicants with criminal histories consistent with applicable federal, state and local law.

Marriott International is the world’s largest hotel company, with more brands, more hotels and more opportunities for associates to grow and succeed. Be where you can do your best work,​ begin your purpose, belong to an amazing global​ team, and become the best version of you.