Claims Services Representative

JOB TITLE: Claims Services Representative

STATUS: Full time, Non-Exempt

DEPARTMENT: Claims Administration

SUPERVISOR TITLE: Claims Administration Supervisor

JOB SUMMARY

The Claims Services Representative will deliver excellent customer service through fast and accurate processing of notices and communications, while coordinating with other departments to resolve claims. The Claims Services Representative acts as the first point of customer contact for general claim inquiries.

ESSENTIAL FUNCTIONS

• Build and maintain business relationships with both internal and external clients by providing prompt and accurate service so to promote customer satisfaction
• Upload claim correspondence in a timely manner to avoid any delays in the claim process
• Assign new claims to Claim Examiners based on outlined criteria
• Assign appropriate vendors to perform mitigation/special services as needed
• Manage Field Adjuster assignments for timely inspections
• Assist with team inquiries while adapting to various communication styles
• Review and analyze claims data to ensure completeness, accuracy, and compliance with company and regulatory standards
• Identify discrepancies or trends in claims data and escalate issues as needed
• Prepare for an increased workload to include overtime should the company be impacted by a catastrophic weather event
• Other duties as assigned

REQUIRED SKILLS & EXPERIENCE

• Expert data entry skills and impeccable attention to detail
• Excellent verbal and written communication skills
• Proficient in Microsoft Outlook, Microsoft Word and Microsoft Excel with extensive working knowledge of Microsoft Excel formulas and spreadsheets
• Ability to manage multiple priorities and meet deadlines within a fast paced and high-volume environment
• Ability to work well in a team-oriented environment, as well as independently
• Strong phone etiquette and customer service experience
• Strong data analysis and proactive problem-solving skills
• Excellent organizational and time management skills

EDUCATION & TRAINING

• High school diploma required; Associate degree preferred

EXPERIENCE

• One year or more related experience and/or training; or equivalent combination and experience in claims support, insurance operations, or a related field
• Experience in mediation scheduling, coordination and managing mediation activities preferred

LICENSES OR CERTIFICATIONS

• Insurance 6-20 License, preferred

HYBRID WORKING & COLLABORATION WEEKS

To foster HCI’s commitment to creating a collaborative work environment, remote workers will be required to report to a central office location for one week every quarter for collaboration, team building, and educational exercises. Attendance during collaboration weeks is a vital component of our team culture, and therefore mandatory unless exceptions are approved through Human Resources. Additionally, employees may be asked to report to the office outside of collaboration weeks as project requirements, team meetings, or other organizational needs that necessitate in-person collaboration occur.

WORK ENVIRONMENT

Work is primarily sedentary in nature. Job operates in a professional office environment. The role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets, and other devices. The employee will be exposed to normal office environment conditions and temperatures. Noise level is low to moderate.

PHYSICAL DEMANDS

The role requires sitting for long periods of time, as well as working with computers and other electronic screens under fluorescent lights.

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