TPL Claims Associate

The TPL Claims Associate plays a critical role in third-party liability (TPL) coordination by managing accounts holistically from initial patient contact to communication with insurance adjusters and attorneys. This position requires direct interaction with hospital access teams, patients, insurance representatives, and legal professionals to gather, verify, and document all necessary information related to accident claims. The ideal candidate will be detail-oriented, organized, and possess excellent communication skills to ensure accurate and timely coordination of benefits.

Essential Duties and Responsibilities:

• Conduct inbound and outbound calls with patients, insurance adjusters, and attorneys while maintaining HIPAA compliance and professional phone etiquette.
• Obtain and document detailed accident information from patients and third parties.
• Collaborate with hospital access teams to ensure accurate and complete data collection.
• Communicate with attorneys to gather legal documentation and updates related to claims.
• Verify claim status with insurance adjusters and follow up as needed.
• Accurately notate accounts and assign tasks to appropriate departments for further action.
• Perform investigative searches (e.g., Scout) to identify potential claims and ensure proper coordination.
• Manage accounts holistically, ensuring all aspects of the claim are addressed from start to resolution.

Qualifications:

• High School Diploma or GED required.
• 1–2 years of experience in administrative, insurance, or telephone communications preferred.
• Strong computer and typing skills.
• Intermediate proficiency in Microsoft Outlook, Excel, and Microsoft Teams.
• Excellent organizational and communication skills.
• Dependable, detail-oriented, and able to work effectively in a team environment.