Customer Service Representative - Claims

Description

• Prepare clear and concise documentation in written and oral communications.
• Collect and submit required paperwork to TPA.
• Send Acknowledgment letters and post-incident paperwork to various.
• Assist with facilitating post-accident drug testing.
• Make effective and appropriate decisions.
• Places outgoing phone calls to claimants, clients, field office representatives, claims adjusters, attorneys, and physicians to follow up on incidents.
• Enter claim data into various claims management systems.
• Refer injured workers to treatment facilitates and arrange for transportation when needed.
• Establish and maintain effective partnerships both internally and externally.
• Answer incoming calls from clients, contractors, field office representatives, claims adjusters, attorneys, and physicians.
• Intake new claims and act as liaison between employee and Third-Party Administrator (TPA).
• Review and verify Injury Reporting forms prior to submission to ensure that accurate information regarding the claim has been provided. Obtain additional information or clarification when needed.
• Assist with return-to-work process.
• Perform clerical tasks and projects as assigned.
• Triages all incoming calls regarding new and existing workers’ compensation claims.
• Interpret and effectively communicate policies and procedures, including read, understand, and apply complex materials. Use proper grammar, spelling, and punctuation in all communications.
• Assist adjuster in investigation of claims by gathering and forwarding information needed to analyze liability and root cause of accident.

Requirements

• Ability to operate a computer keyboard with accuracy and speed.
• Prior insurance experience in claims and/or call center experience preferred.
• Experience performing highly, independent, complex clerical work involving extensive record keeping.
• High School Diploma required.
• Experience with using multiple software and platforms.
• Comfortable with working in a team environment.
• Ability to work under stringent deadlines to include prioritizing work in a high-volume multi-task environment with numerous interruptions.
• Deal effectively and professionally with adverse and difficult situations.
• Minimum one (1) year customer service experience required.

Benefits

Compensation: $21.63/hrs (annualized at $45,000) + quarterly bonuses

Training + Development

Interview process

Visa Sponsorship

Security clearance