Claims Customer Service Representative - 1160

Security Mutual Life Insurance•Binghamton, NY

8d•$19 - $21•Hybrid

About The Position

As a Claims Customer Service Representative, you will be the initial point of contact for claimants, beneficiaries, policyowners, agents, providers, and other authorized parties regarding life and supplemental health claims. You will handle incoming and returned calls, process first notice of loss, provide accurate claim status information, send required correspondence and forms, and document interactions and outcomes in the appropriate systems. The role requires empathetic, professional service while protecting confidential information and following established claims procedures and service standards. The position is primarily remote, with periodic time required at the assigned Company office in Binghamton, NY, or Houston, TX. The role supports the Claims call queue and requires maintaining established service metrics. The pay range is $19.02 to $21.03 per hour. Starting pay depends on factors including location, education, experience, and skills. Visa sponsorship and relocation assistance are not available.

Requirements

At least 2 years of customer service experience.
Experience in an insurance industry or call center environment.
Basic knowledge of Microsoft Word and Excel.
Excellent written and verbal communication skills.
Excellent data-entry skills.
Ability to perform work accurately and thoroughly.
Ability to pay close attention to detail.
Ability to prioritize and organize a heavy workload.
Ability to work a flexible schedule with occasional overtime.
Associate’s degree in business or a related field.

Nice To Haves

Health insurance industry customer service experience is preferred.
Fluency in Spanish is a plus.

Responsibilities

Respond to incoming calls and complete return calls about life and supplemental health claims in a timely, courteous, and professional manner.
Process first notice of loss for all claim types by gathering accurate information, verifying available policy and claimant details, and initiating claims in the appropriate system.
Explain the claims process, required documentation, and next steps in understandable language while following role boundaries and established procedures.
Provide accurate, current information about claim status, outstanding requirements, and correspondence using approved systems and resources.
Assist callers with empathy, patience, and professionalism, including those experiencing loss, illness, or other difficult circumstances.
Document each call and interaction in the appropriate system, including the reason for contact, information exchanged, actions taken, commitments, and outcome.
Prepare and send follow-up letters, claim forms, and other required correspondence between calls, accurately and within service standards.
Research information across multiple systems and resources to answer inquiries, confirm claim details, and support accurate processing.
Route inquiries and claim-related information to the appropriate Claims team member or department.
Promptly escalate questions, complaints, sensitive matters, or potential issues requiring additional review.
Protect confidential, personal, and health information and follow applicable privacy, security, and records-handling requirements.
Maintain current knowledge of claims procedures, products, forms, systems, and service expectations through training, reference materials, and coaching.
Meet established Claims call-queue service metrics, including availability, responsiveness, call handling, and completion of follow-up activities.
Perform other duties and responsibilities as needed or assigned by management.