Claims Customer Service Rep II

Immediate need for a talented Claims Customer Service Rep II. This is a 12+ Months Contract opportunity with long-term potential and is located in Moines, IA (Onsite). Please review the job description below and contact me ASAP if you are interested.

Job ID:25-63914

Pay Range: $15 - $15.50/hour.  Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan.
 
Key Responsibilities:

• Provides first line customer service contact for claims reporting activity. Utilizes claims call center best practices in all activities.
• Creates loss reports by securing information from policyholders, claimants, agents, and other parties. Establishes the claim master record by direct entry of claim data via computerized claim system. Takes manual loss reports as necessary.
• Verifies coverage under various policies or policy provisions based on variances of state, jurisdiction and regulatory requirement.
• After taking notice of loss, makes direct assignments to inside or field claims adjustment personnel. In the absence of the supervisor, assigns claims of other claims service representatives within established guidelines and procedures.
• Refers claimants to preferred repair shops or schedules drive-in appointments as appropriate.
• Handles inquiries from policyholders, claimants, and others appropriately.
• Establishes and maintains a follow-up system for completion of incomplete claim reports. Proactively contacts policyholders/claimants for additional information to expedite proper handling of claims.
• Maintains, records and report information.
• Handles customer service complaint situations as appropriate, or provides information to escalate for resolution
• Creates and maintains information screens. Inputs data into other personal computer-based software as required.
• Handles the duties of coverage verification with other appropriate functions for all state operations when circumstances do not allow a claim to be established on the system. This would include the verification of Assigned Risk as well as Voluntary policy information.
• Provides technical advice to claims service representatives on personal and commercial lines policy coverage in the absence of a supervisor.
• Performs other duties as assigned.

Key Requirements and Technology Experience:

• Skills-Processing Transactions, Sorting/stuffing envelopes and Customer Support.
• High school studies. Post-high school studies or insurance industry coursework preferred.
• Claims Service Representative I experience and successful completion of formal and on-the-job training of 3-12 months.
• Extensive knowledge of the duties and responsibilities of the claims service representatives with proven performance as indicated in quality program results.
• Superior knowledge of claims processing system(s) and the claims reporting process as well as thorough knowledge of insurance coverage, policies and claims handling procedures.
• Ability to make decisions such as the application of coverage, assignments, and work priorities.
• Outstanding oral and written communication skills needed to effectively interact with the policyholders, claimants, agents and co-workers.
• Ability to efficiently operate personal computer and all related claims/business software.
• Some positions provide service primarily for customers speaking a language other than English.
• These positions may require skills specific to the language and culture, including bilingual skills.
• Credit Check: A valid credit check and/or background check may be required as part of the selection process in locations where a State Department of Insurance license is required for the position.

Our client is a leading insurance and financial services Industry and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.
 
Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

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