Claims Representative

Redion • Pembroke Pines, FL

1d • Hybrid

About The Position

Embark on a Journey That Makes a Difference. At Redion, every day is an opportunity to help people explore the world with confidence. We�re not just in the business of protection�we�re in the business of adventure and peace of mind. Whether it�s a backpacker trekking through the Andes, a family cruising the Mediterranean, or a solo traveler chasing the Northern Lights, we�re there to ensure their journey is safe and supported. From assisting with emergency medical claims to guiding customers through trip disruptions or ID theft, your work helps turn travel challenges into stories of resilience. Set Sail on a Career Path to Success. Our teams value curiosity and collaboration while priding ourselves on fostering a welcoming and inclusive atmosphere for our employees. Elevate your journey through our internal programs, including: Diversity, Equity, and Inclusion (DEI) Committee Career pathing and Individual Development Plans Internal training and intern opportunities Women in Business Mentorship Program Employee awards and recognition Education and professional development assistance program Passport to Perks Includes: Generous Employer contribution for health, dental, and vision insurance Paid Maternity and Paternity Leave Scholarship Program for Employee Dependents Company match on 401k Employee Assistance Program (EAP) Company paid short-term and long-term disability insurance Company paid life insurance Voluntary Pet Insurance Voluntary Legal Benefit Discounts on travel insurance Time off policies including vacation days, sick days, personal days, holidays and volunteer days (VTO)

Requirements

• High School Diploma or Equivalent (GED) required.
• Exceptional communication, problem-solving, and organizational skills.
• Strong reading, writing, comprehension, and proofreading skills.
• Knowledge of standard concepts, practices, regulations, and laws within insurance field preferred.
• Bilingual English/Spanish language fluency � verbal, reading, and writing skills, is a plus.
• Previous claims and customer service experience are highly preferred.

Nice To Haves

• Bilingual English/Spanish language fluency � verbal, reading, and writing skills, is a plus.
• Previous claims and customer service experience are highly preferred.

Responsibilities

• Analyzing and processing insurance claims to determine the extent of the insurance carrier�s liability in a manner that supports the mission, values, and standards of the Company.
• Efficient adjudication of insurance claims, both phone and written communication with insureds, travel suppliers, medical facilities, and others.
• Maintaining all state Department of Insurance regulations for claims files.
• Process all claims assigned in a timely, efficient, and accurate manner ensuring that all appropriate policies, procedures, and standard best practices are being followed.
• Review information on claim forms, Physician Statements, and other documentation to ascertain completeness and validity of claims.
• Correspond with insureds, physicians, agents, and other appropriate parties to obtain proper documentation and to finalize claims.
• Maintain proper reserves on each claim file.
• Ensure that proper file documentation is collected and maintained, including all records of correspondence and telephone conversations.
• Investigate claims and direct the activities of outside adjusters and investigators.
• Issue denial of benefits letters when appropriate.
• Process attorney represented claims files.
• Review and respond to Department of Insurance complaint letters.
• Respond to written and phone inquiries regarding claims status.
• Issue payments in a timely and accurate manner.
• Ensure that current Federal and State insurance claims regulations, laws, and best practices are being employed consistently for all jurisdictions.
• Answer questions and respond to inquiries from internal and external customers regarding coverage issues and general policy information.
• Assist in the mentoring and training of other employees as directed.
• Perform other duties or special projects as assigned by the management team.

Benefits

• Generous Employer contribution for health, dental, and vision insurance
• Paid Maternity and Paternity Leave
• Scholarship Program for Employee Dependents
• Company match on 401k
• Employee Assistance Program (EAP)
• Company paid short-term and long-term disability insurance
• Company paid life insurance
• Voluntary Pet Insurance
• Voluntary Legal Benefit
• Discounts on travel insurance
• Time off policies including vacation days, sick days, personal days, holidays and volunteer days (VTO)

What This Job Offers

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