CTP Claims Examiner

CTP, Claims Examiner

At WorldTrips, a proud member of the Tokio Marine HCC group of companies, we believe in more than just businesswe believe in empowering our people. As a global leader in specialty travel medical and trip protection insurance, we are passionate about preparing travelers for the unpredictable while fostering a work environment where bold ideas and transformative solutions are valued at every level. Our mission, "To Be a Good Company," reflects our commitment to people and community, recognizing the importance of giving back and driving positive change.

We are proud to be named as a Top Workplace Winner for the past four years by IndyStar!

If you are a motivated professional with the skills and experience to succeed in this role, we encourage you to apply and join our team. Join a team where your success is our priority!

This role is Hybrid, you must be able to come into Carmel, IN office.

Key Responsibilities:

In this role, you will be responsible for investigating, evaluating, and processing travel insurance claims while delivering exceptional customer service. You'll work closely with claimants, healthcare providers, and internal teams to ensure claims are handled accurately, efficiently, and in accordance with policy provisions.

What You'll Do:

• Investigate and evaluate travel insurance claims by reviewing documentation, medical records, and policy information.
• Determine coverage eligibility by interpreting policy terms, conditions, exclusions, and claim details.
• Communicate with claimants, policyholders, healthcare providers, and vendors to gather information and provide updates throughout the claims process.
• Make fair, timely, and well-documented claim decisions, including approvals, partial approvals, and denials.
• Analyze claim information to identify discrepancies, missing documentation, or issues requiring additional review.
• Maintain accurate claim files and document all claim activity within company systems.
• Coordinate benefits and recoveries with other insurance carriers or third-party administrators when appropriate.
• Escalate complex or high-exposure claims to senior team members as needed.
• Deliver a high level of customer service by responding promptly and professionally to inquiries.
• Stay current on company procedures, policy updates, and industry best practices through ongoing training.
• Support audits, testing, process improvements, and other departmental initiatives as assigned.
• Collaborate with teammates to achieve departmental goals and contribute to a positive team environment.

Skills and Experience Needed:

• High school diploma or GED required; Associate's or Bachelor's degree in Business, Insurance, Healthcare Administration, Risk Management, or a related field preferred.
• Up to two years of experience in customer service, insurance, claims, healthcare, financial services, or a related field.
• Previous claims handling, insurance administration, or travel insurance experience is a plus.
• Strong analytical and critical thinking skills with the ability to make sound decisions based on policy guidelines.
• Excellent written and verbal communication skills with the ability to explain complex information clearly and professionally.
• Strong organizational skills with the ability to manage multiple priorities in a fast-paced environment.
• High attention to detail and the ability to maintain accurate documentation.
• Proficiency with Microsoft Office applications, including Outlook, Excel, and Word.
• Comfortable learning and using multiple claims management systems and technology platforms.
• A customer-focused mindset with the ability to handle sensitive situations with professionalism, empathy, and discretion.

What We Offer

• Hybrid Schedule, 4 days work from home and 1 day in office
• Strong learning culture with ongoing development opportunities
• Comprehensive medical, vision, and dental coverage, with eligibility beginning on your first day of employment
• Basic life and disability insurance
• 401(k) plan with 6% company match
• 20 days of PTO, two floating holidays, approximately 11 paid holidays, and volunteer time off
• Paid parental leave
• Access to our award-winning wellness program, including mental health services, fitness network membership, and a complimentary Headspace subscription
• Student loan matching program

WorldTrips is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to age, ancestry, citizenship, color, family or medical care leave, gender identity, genetic information, marital status, medical condition, national origin, physical or mental disability, protected veteran or military status, race, ethnicity, religion, sex (including pregnancy), sexual orientation, or any other characteristic protected by applicable local laws, regulations and ordinances.