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Claims Service Representative
2 months ago
We are seeking a highly skilled Claims Service Center Associate to join our team at EMC Insurance. As a Claims Service Center Associate, you will play a critical role in delivering exceptional service to our customers by resolving their claims in a timely and professional manner.
Key Responsibilities- Resolve internal and external customers' calls via the claims service center toll-free number.
- Deliver exceptional service throughout the initial stages of reporting a claim.
- Intake first notice of loss reports via phone, fax, and email, and complete setup within the appropriate claims systems.
- Investigate, analyze, and resolve inquiries from various claims parties and customers utilizing multiple systems and resources.
- Research and provide solutions to problems with a single-call resolution expectation and partner with Claims staff for more complex, multi-contact solutions.
- Service first notice of loss claim calls on the claims service toll-free number.
- Determine if claim meets predetermined criteria for escalation procedures and escalate to appropriate Claims team members.
- Verify policy coverages and limits for agents and policyholders using claims and policy systems and authorize and reserve car rental, road service/towing, etc.
- Process new claims from agencies and branch offices received via phone, voicemail, or emails.
- Evaluate incomplete claims files received through email from after-hours service vendor to resolve the first notice of loss process, including making outbound calls to agencies/brokerages, policyholders, and other claims parties.
- Review daily integrated, uploaded files from after-hours service partner to ensure claims are formatted correctly, complete, and avoid duplication.
- Service claim inquiry calls from agents, policyholders, and claimants such as claim status, adjuster contact information, body shop options, etc., via the claims service toll-free number.
- Answer claimants' questions by using various resources and systems.
- Act as gatekeeper for the Claims operation by directly servicing or routing calls to appropriate staff.
- Evaluate requests made through the after-hours service partner and make outbound calls to provide solutions.
- Respond to inquiries from internal and external customers with facts or solutions within established time frames.
- Partner with members of the Claims staff when providing additional file documentation (i.e., loss photos, receipts, etc.) to ensure documentation is attached to appropriate claim files.
- Collaborate with peers and management to implement suggestions and improve Claims Service Center key performance indicators (KPIs) and the overall customer experience.
- Research and continue to build knowledge of policy coverage, general claims handling, company processes, resources, and systems.
- High school diploma or equivalency.
- Associate degree preferred.
- Two years of business or insurance experience, preferably claims, claim support, or customer service experience.
- Inbound call center experience preferred.
- Insurance, customer service coursework, or designations preferred.
- Good knowledge of insurance and claim terminology.
- Ability to read and interpret basic coverages and policy limitations.
- Ability to answer calls with empathy while asking probing questions and actively listening to customers.
- Ability to troubleshoot situations and problems that may arise while working with callers.
- Strong and accurate keyboarding and data entry skills in addition to basic knowledge of Microsoft Office Suite and Adobe PDF Viewer.
- Ability to multi-task and meet deadlines.
- Strong written and verbal communication skills.
- Excellent telephone etiquette and customer service skills.
- Ability to work in a fast-paced and team environment.
Per the Colorado Equal Pay for Equal Work Act, the hiring range for this position for Colorado-based team members is $20.61/hour - $26.47/hour. The hiring range for other locations may vary.
Our employment practices are in accordance with the laws that prohibit discrimination due to race, color, creed, sex, sexual orientation, gender identity, genetic information, religion, age, national origin or ancestry, physical or mental disability, medical condition, veteran status, active military status, citizenship status, marital status, or any other consideration made unlawful by federal, state, or local laws.
All of our locations are tobacco-free, including in company vehicles.
