Claims Specialist

Claims Specialist
This Claims Specialist handles customer enrollments and inquiries, claims processing, and contractor dispatching. Training hours are Monday thru Friday 9:00 am to 6:00 pm; work schedule will be Monday thru Friday 11:00 am to 8:00 pm, with one Saturday required (candidate availability must be between 8:00 am and 8:00 pm).

Primary Responsibilities:

Customer Call Duties

  • Interact with current and potential customers via telephone.
  • Provide customers with product information on Home Warranty programs.
  • Maintain satisfactory knowledge of service agreements.
  • Enroll customers in IGS programs via phone, mail, or email requests.
  • Handle claim calls including interacting with customers, verifying customers' eligibility to file claims, verifying all facts related to claims and filing claims into the company's claim system.
  • Inform customers of repair or replacement procedures for a covered claim.
  • Locate and dispatch contractors to repair or replace covered lines or systems and inform customers accordingly.
  • Navigate systems, procedures and other resources to provide accurate and timely resolutions to customer inquiries, claims or program related complaints.
  • Achieves all customer experience and sales standards set for the department by following the established departmental goals, policies and procedures.
  • Additional duties and responsibilities as assigned.
Contractor Call Duties
  • Schedule repairs, complete and distribute claim forms, and provide contractors with appropriate authorization information to execute repairs.
  • Maintain contact and follow-up with the contractor and customer throughout the claim process to ensure efficient repair or replacement.
  • Review claims over the authorization limit level, review claim amount to verify additional costs, and provide appropriate approval for plan limit.
Afterhours Call Duties
  • Handle claims and escalated customer calls on assigned dates after business hours
Required Skills:
  • Experience with customer service in a phone center environment.
  • Strong reasoning, decision making, and communication skills.
  • Organized and detail oriented with excellent problem solving abilities.
  • Experience with third party service relationships.
  • Able to empathize, listen and assist customers during the claim process.
  • Operate effectively in a team environment.
  • Adaptability/Flexibility: Adapts to change, is open to new ideas, takes on new responsibilities and handles pressure.
  • Self-Motivating
  • May be required to participate in certain insurance classes or obtain a Property & Casualty license.
Minimum Education & Experience:
  • High school diploma or equivalent.
  • Exposure to call center/customer service environment preferred.
  • Prior experience in claims processing is a plus.

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