Claims Customer Service Representative - 1161

Security Mutual Life Insurance•Binghamton, NY

4d•Hybrid

About The Position

As a Claims Customer Service Representative, you will serve as 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 claim status information, send required correspondence and forms, and document interactions and outcomes in the appropriate systems. The role delivers 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. Applicants residing in the Greater Houston or Greater Binghamton area may be suited to the role.

Requirements

At least 2 years of customer service experience.
Experience in an insurance industry or call center environment.
Associate’s degree in business or a related field.
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.

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 regarding life and supplemental health claims in a timely, courteous and professional manner.
Process first notice of loss for all claim types by gathering complete and accurate information, verifying available policy and claimant details, and initiating the claim in the appropriate system.
Explain the claims process, required documentation and next steps in clear, understandable language while following the scope of the role and established procedures.
Provide accurate, up-to-date information about claim status, outstanding requirements and correspondence using approved systems and resources.
Demonstrate empathy, patience and professionalism when assisting callers experiencing a loss, illness or other difficult circumstances.
Document each call and interaction in the appropriate system, including the reason for contact, information provided or received, actions taken, commitments made and outcome.
Prepare and send follow-up letters, claim forms and other required correspondence during periods between calls, accurately and within established service standards.
Access and research information across multiple systems and resources to respond to inquiries, confirm claim details and support accurate processing.
Route inquiries and claim-related information to the appropriate Claims team member or department for review and handling.
Identify questions, complaints, sensitive matters or potential issues requiring additional review and promptly escalate them to the appropriate resource or management.
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.
Maintain established Claims call queue service metrics, including availability, responsiveness, call handling and completion of required follow-up activities.
Perform other duties and responsibilities as needed or assigned by management.