Claims Resolution Specialist

$40,500 - $68,900/Yr

Combined Insurance - Chicago, IL

posted about 1 month ago

Full-time - Entry Level
Chicago, IL
Insurance Carriers and Related Activities

About the position

The Resolution Specialist at Combined Insurance will play a crucial role in processing entry-level claims and addressing escalated customer inquiries. This position is designed for individuals looking to develop their skills in claims adjudication while providing excellent customer service. The role involves working closely with policyholders to ensure accurate and timely claims processing, making it essential for maintaining customer satisfaction and supporting the company's operational goals.

Responsibilities

  • Process entry-level claims including payment and status updates.
  • Address and resolve escalated customer inquiries via phone or email.
  • Review, process, and accurately pay claims on supplemental coverage according to company procedures and state regulations.
  • Request additional information from policyholders and providers to finalize claims.
  • Manage pending files and handle customer inquiries with a customer-centric approach.
  • Create claim-related correspondence and provide customer service to internal and external customers.
  • Meet department standards for time service and quality.
  • Build knowledge of customer and product management policies and procedures.
  • Support process improvements and provide feedback to leadership.
  • Perform other duties as assigned.

Requirements

  • 0-1 years of experience in claims preferred.
  • High school diploma required.
  • 5+ years of experience in a call center environment preferred.
  • Strong organizational skills with attention to detail.
  • Excellent written and verbal communication skills.
  • Ability to work in a fast-paced environment and manage competing priorities.
  • Analytical with good decision-making skills.
  • Proficient in MS Office Suite.
  • Medical terminology knowledge preferred.
  • Insurance experience preferred.

Nice-to-haves

  • Bilingual (English/Spanish) is a plus.

Benefits

  • 401(k) matching
  • Dental insurance
  • Disability insurance
  • Health insurance
  • Life insurance
  • Referral program
  • Tuition reimbursement
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