Claims Associate - Consumer (Bilingual)

Sedgwick • West Lake, OH

1d

About The Position

Processes claims and determines benefits due under credit card or other financial program benefit plans, makes timely payments and adjustments for specified program claims, and provides superior customer service. The role processes first-party property claims according to basic coverage defined by client-specific programs, investigates and evaluates claims to make coverage determinations, and adjudicates settlements or denials within the designated authority level. The associate handles a high volume of claims, phone calls, and correspondence while maintaining properly documented claim files and meeting quality and production goals, customer guidelines, and deadlines. Professional Spanish fluency is required. A credit security clearance confirmed through a background credit check is required.

Requirements

• High school diploma or GED.
• One year of general office experience, or an equivalent combination of education and experience.
• Professional fluency in reading, writing, and conversing in Spanish.
• Licenses as required, or willingness and ability to work toward obtaining appropriate licenses as required.
• Knowledge of first-party property and casualty claim adjudication as applicable to the line of business.
• Good oral and written communication, including presentation skills.
• Computer literacy, including Microsoft Office products.
• Analytical and interpretive skills.
• Good organizational and interpersonal skills.
• Ability to work in a team environment and meet or exceed performance competencies.
• Credit security clearance confirmed through a background credit check.

Nice To Haves

• Claims industry experience.

Responsibilities

• Process first-party property claims based on basic coverage defined by client-specific programs.
• Investigate and evaluate claims to make coverage determinations.
• Adjudicate settlements or denials up to the designated authority level.
• Handle a high volume of claims, phone calls, and correspondence while properly documenting claim files.
• Meet quality and production goals, customer guidelines, and deadlines.
• Perform other duties as assigned.
• Support the organization's quality programs.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED