Claims Services Representative (Litigation)

JOB SUMMARY

The Claims Services Representative (Litigation) supports the Claims Administration Team with a specialized focus on Quality Assurance (QA) and litigation-related claim handling. The CSR plays a key role in identifying performance trends, supporting litigation processes, and maintaining high-quality standards throughout the claim lifecycle.

ESSENTIAL FUNCTIONS

• Conduct ongoing quality reviews of LitTPA CSR tasks to ensure accuracy, compliance, and adherence to company policies and procedures
• Document findings in the QA dashboard, including missed opportunities, trends, errors, and best practices
• Enter weekly updates into the QA dashboard
• Generate weekly QA reports to management, summarizing team performance, missed opportunities, and positive outcomes
• Partner with the supervisor to provide coaching and guidance to team members
• Conduct observations and side-by-sides to identify strengths and areas for development
• Assist in delivering refresher training or skill-enhancement sessions as needed
• Identify recurring issues, operational gaps, and recommend areas for improvement through QA data
• Track improvements over time to measure effectiveness of implemented changes
• Process all incoming Civil Remedy Notices

REQUIRED SKILLS & EXPERIENCE

• 3+ years’ experience in a Claims Services Representative role at an insurance company
• 2+ years’ experience and/or training within a claims services or litigation support department preferred, or equivalent experience
• Familiarity with legal/litigation processes related to insurance claims is preferred
• High degree of accuracy and attention to detail in a high-volume environment
• Ability to interpret QA data and prioritize in a fast-paced, high-volume environment
• Ability to identify trends and provide actionable QA insights
• Proficient with Microsoft Outlook, Word, Access, Excel
• Strong phone etiquette required
• Proven capability to communicate effectively verbally and written
• Ability to work well in a team-oriented environment, as well as independently

EDUCATION & TRAINING

• High School Diploma required; Associate degree preferred

LICENSES OR CERTIFICATIONS

• 6-20 Adjuster License required within 60 days of employment

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.

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