Customer Resolution Specialist in Milwaukee, WI at National General Insurance

Date Posted: 11/30/2019

Job Snapshot

Job Description

Primary Purpose:

Research and respond to formal complaints on behalf of all areas of National General Accident and Health Company.


Essential Duties and Responsibilities:

Following is a summary of the essential functions for this job. Other duties may be performed, both major and minor, which are not mentioned below. Specific activities may change from time to time.

  • Coordinate, research, and make recommendations/decisions on resolutions to formal complaints received from various sources, including the Attorney Offices, Provider Offices, Members, Sales Agents and other sources
  • Coordinate, research, and make decisions regarding premium refunds based on requests from members
  • Create and send specific written responses regarding any decisions that are made within the state-required timeframes
  • Log complaints appropriately to be reported back to the state and internal management as required
  • Prepare complaints to be presented at Grievance Panel by the Grievance Panel Coordinator
  • Identify coaching opportunities, process improvements, and system issues and share with the appropriate parties
  • Communicate decisions to Third Party Administrators to correct claims, update eligibility, or any other action needed to complete a complaint
  • Provide support to complete Insurance Department and Better Business Bureau Complaints
  • Be a subject matter expert in all aspects of all Accident and Health products including applications, claims, billing, and administrative rules


Minimum Skills and Competencies:

The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Bachelor Degree or in-lieu of degree equivalent education, training and work-related experience
  • 3+ years of Customer Service, Claims, or Appeal experience specifically in Health Insurance
  • 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 regards 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


Desired Skills:

  • Prior experience researching and responding to formal consumer and legal complaints
  • Experience with National General Insurance programs for all states and lines of business
  • Experience with the claim-handling process
Job posting ID: 2019-3412

Job Requirements


About National General Holdings:

National General Holdings Corp. is headquartered in New York City. National General traces its roots to 1939, has a financial strength rating of A– (excellent) from A.M. Best, and provides personal and commercial automobile, homeowners, umbrella, recreational vehicle, motorcycle, supplemental health, and other niche insurance products. We are a specialty personal lines insurance holding company. Through our subsidiaries, we provide a variety of insurance products, including personal and commercial automobile, homeowners, umbrella, recreational vehicle, supplemental health, lender-placed and other niche insurance products.

National General is a fast paced, dynamic, and entrepreneurial organization. Our team members live by and exemplify what we call the 4Es. At National General, we are Energized, Engaged, Empowered, and we Execute every day in order to provide an exceptional experience for our customers! We are passionate about our organization and the value that we add every day. A successful candidate with National General will embody the 4Es. Our team is poised to outperform the competition. We are National General Insurance and with us you can be extraordinary! Come join our team!

Companies and Partners

Direct General Auto & Life, Personal Express Insurance, Century-National Insurance, ABC Insurance Agencies, NatGen Preferred, NatGen Premier, Seattle Specialty, National General Lender Services, ARS, RAC Insurance Partners, Mountain Valley Indemnity, New Jersey Skylands, Adirondack Insurance Exchange, VelaPoint, Quotit, HealthCompare, AHCP, NHIC, Healthcare Solutions Team, North Star Marketing, Euro Accident.

In addition to a phenomenal career opportunity, National General Insurance offers an excellent benefits package including:

• Paid Training
• Medical, Dental, Vision benefits
• Wellness Programs
• Life and Short/Long Term Disability Insurance
• 401k w/ Company Match
• Company Paid Holidays & Generous Time-off policy
• Employee Discount Program
• Career Advancement and Development Opportunities
• On-site Healthcare Clinic (Winston-Salem and Cleveland offices)
• On-site Fitness Center (Cleveland and Dallas offices)
• Subsidized parking (Cleveland office)

National General Holdings Corp. is an Equal Opportunity (EO) employer – Veterans/Disabled and other protected categories. All qualified applicants will receive consideration for employment regardless of any characteristic protected by law. Candidates must possess authorization to work in the United States, as it is not our practice to sponsor individuals for work visas.

In the event you need assistance or accommodation in completing your online application, please contact NGIC main office by phone at (336) 435-2000.



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