Claims Service Representative (Administrative)

This position supports the Claims Division in achieving and promoting the lowest fair claims settlement.  This position is responsible for the routine administrative and customer service aspects of the claims handling process according to the established guidelines of the Claims Division.

 

ESSENTIAL DUTIES AND RESPONSIBILITIES

 

Team Building

• Adheres to the work group's expectations and guidelines; fulfills team or work group responsibilities; demonstrates personal commitment to group goals.
• As directed by leadership, this position will be responsible for training team members on current processes.

Attention to Details

• Enters data into the claims processing systems as instructed by the Team Leaders, Claims Managers, or adjusters while adhering to quality and productivity guidelines established by the claims division.
• Inputs the proper coverage(s) and classification(s) when setting up new claims.

Quality Orientation

• Performs duties outside of the claims systems such as filing, distribution of mail, check printing, and other various tasks in support of the claims division.
• During periods of high claim volume, provides prompt and professional customer service to agents, policyholders, and internal customers regarding new claim notifications, inquiries, and requests received via telephone, fax, email, or internet.

Planning & Organizing

• Researches policy and other systems to resolve claims processing issues.

Positive Approach

• Communicates with internal and external customers by phone, fax, and e-mail in a professional and courteous manner.

Applied Learning

• Puts new knowledge, understanding, or skill to practical use on the job; furthers learning through practice and ongoing feedback.
• Readily absorbs and comprehends new information and develops skills from formal and informal learning experiences.

 

Performs various projects requested or assigned by the employee's reporting manager noted above.

 

SPECIAL RELATIONSHIPS OF THE CLAIMS SERVICE REPRESENTATIVE

• Direct contact with the Claims Service Office Managers, Team Leaders, and adjusters
• Direct contact with various levels of Home Office Claims personnel
• Direct contact with various levels of Underwriting personnel

QUALIFICATIONS FOR THE CLAIMS SERVICE REPRESENTATIVE

 

Education/Credentials

• High School diploma or equivalent

 

Experience

• Prior customer service experience preferred

 

Technical/Professional Knowledge

• Good interpersonal skills with the ability to interact in a professional and tactful manner
• Good communication skills – both verbal and written
• Good Personal Computer skills with an emphasis on Microsoft Office Suite
• Strong keyboard, data entry, and typing skills required, along with the ability to perform various clerical duties
• Ability to perform standard business mathematics
• Must be able to multi-task and perform job responsibilities with the interruption of phone calls
• Must be able to work as a team member in a fast-paced environment
• Must be adaptable and able to quickly adapt to schedule changes

 

JOB REQUIREMENTS (as required by ADA – Americans with Disabilities Act)

• This position is primarily a sedentary position that requires occasional standing and walking throughout the office environment.
• Must be able to see and effectively use a computer monitor.
• Must be able to operate a computer, keyboard, and applicable printers and other general office equipment.
• Must be able to access and enter information accurately using automated systems.
• Must be able to hear and communicate via the telephone and/or monitoring devices to both internal and external clients.
• Must be able to present information to individuals and groups.
• Must be able to interpret and apply concepts that may or may not be based upon established guidelines.
• Must be able to maintain acceptable attendance and adhere to scheduled work hours.