Customer Service Claims Representative

Position Overview

We are seeking a Customer Service Claims Representative to support the claims application and intake process in a fully remote environment. This position is responsible for accurately entering claim information, assigning new claims to the appropriate claims handler, communicating with customers regarding required documentation and claim status, and helping customers connect with the appropriate resources to resolve questions or concerns.

The ideal candidate has previous call center or customer service experience, strong computer skills, and the ability to work efficiently across multiple systems while providing professional and accurate customer support.

Work Location

• Work Model: 100% Remote

• Preferred Time Zones: Eastern or Central

• Candidates cannot be hired in California or New York.

• Equipment will be provided, including:

  • Desktop computer

  • Monitors

  • Keyboard

  • Mouse

  • Headset

• Depending on equipment delivery, employees may need to use a personal device to attend the beginning of training.

Internet & Remote Work Requirements

• Must have reliable broadband internet service.

• Computer, telephone, and VPN equipment must be able to connect directly to the home router.

• Employees cannot work over Wi-Fi, regardless of upload or download speed.

• Must have an appropriate home setup that allows company equipment to be hardwired directly to the router.

Training Schedule

Training Start Date: Monday, October 26

• Monday – Friday

• 8:00 AM – 5:00 PM ET

• 1-hour unpaid lunch

Attendance during scheduled training and work hours is required.

Schedule After Training

Hours of Operation: 10:00 AM – 8:00 PM ET, 7 days per week

• Employees will work 5 days per week.

• One scheduled workday will be a weekend day.

• Employees will have one weekend day off and one additional day off during the week.

• Shifts are 8 hours with a 30-minute lunch.

Possible Assigned Shifts

• 10:00 AM – 6:30 PM ET

• 10:30 AM – 7:00 PM ET

• 11:00 AM – 7:30 PM ET

• 11:30 AM – 8:00 PM ET

Candidates must be comfortable with the assigned schedule and weekend requirement.

Key Responsibilities

Claims Intake & Processing

• Expedite the customer service claims application process.

• Assign new claims to the appropriate claims handler.

• Accurately enter verbal and written claim application information into the claims management system.

• Ensure information entered meets internal and external customer requirements.

• Review claim information and assist with obtaining required documentation.

• Support timely and accurate processing of customer claims.

Customer Service & Communication

• Communicate with customers by telephone, written correspondence, and/or the claims management system.

• Inform customers of documentation required to process their claims.

• Explain required timeframes and provide updates regarding claim status.

• Assist customers in identifying the appropriate contact person to resolve claims-related questions or problems.

• Communicate clearly, professionally, and accurately regarding all aspects of the claims process.

• Provide a high level of customer service throughout each interaction.

Administrative & Systems Support

• Accurately document customer and claim information within the claims management system.

• Navigate multiple computer systems simultaneously while communicating with customers.

• Utilize Microsoft Office applications as required.

• Maintain accurate and complete documentation.

• Follow established procedures, quality standards, and service expectations.

Additional Responsibilities

• Participate in and maintain a quality-service culture within the Customer Service team.

• Support organizational quality programs.

• Maintain reliable attendance during all scheduled work hours.

• Perform additional duties as assigned.

Qualifications

• Previous customer service or call center experience preferred.

• Claims or insurance experience is beneficial but not required unless otherwise specified.

• Strong verbal and written communication skills.

• Strong customer service and telephone skills.

• Comfortable working with Microsoft Office applications.

• Ability to navigate and work within multiple computer systems simultaneously.

• Strong data-entry skills with attention to accuracy.

• Ability to follow established procedures and documentation requirements.

• Strong organizational and time-management skills.

• Ability to work independently in a remote environment.

• Must be comfortable working one weekend day each week.

Required Pre-Screening Questions

Please provide the candidate's answers to the following questions with each submission:

1. Have you ever worked in a call center before?
   Please describe your call center and customer service experience.

2. What experience do you have working from home?
   Please describe your previous remote-work experience and home-office setup.

3. How comfortable are you using Microsoft Office and working within multiple systems at the same time?
   Please provide an example from your previous experience.

4. What do you like and dislike about your current or most recent work environment?

5. Are you able and willing to work one weekend day each week?

Selection Process

Managers will not be conducting interviews for this opening. Candidates will be selected based on their resume, qualifications, and submitted pre-screening responses.