Claims Support Representative (Hybrid After Training)

One80 • Peoria Heights, IL

2d • Hybrid

About The Position

The Claims Support Representative is the first point of contact for customers initiating insurance claims. This role is responsible for managing customer inquiries and claim submissions, ensuring accuracy and efficiency in the intake process. This crucial step sets the foundation for the claims management journey and plays a key role in shaping overall customer experience.

Requirements

• High school diploma or equivalent required
• 1-3 years of customer service, insurance, or claims-related experience preferred
• Strong communication and interpersonal skills
• Excellent attention to detail and data accuracy
• Ability to multitask in a fast-paced environment
• Proficiency in claims management systems and office software
• Knowledge of life and health insurance policies and terminology

Nice To Haves

• Associate degree preferred

Responsibilities

• Respond promptly to customer inquiries, address concerns with professionalism, and provide clear guidance throughout the claims filing process. Act as the primary point of contact, ensuring a seamless customer experience until the claim is successfully submitted to the carrier for processing.
• Receive, review, and process insurance claim documents for carriers, ensuring accuracy and compliance with company policies and procedures. For certain carriers, this role involves directly entering benefits into their CRM system, requiring meticulous attention to detail and a high level of accuracy.
• Serve as the subject matter expert beyond the initial frontline Customer Service role, providing in-depth interpretation of customer policies and coverage. Accurately assess claim eligibility and determine applicable coverage, ensuring clarity and compliance with company guidelines.
• Ensure precise and up-to-date records of all claims, communications, and resolutions, maintaining compliance with company policies and industry regulations.
• Accurately document all claim-related activities and interactions, adhering to company procedures to support transparency, efficiency, and seamless claims processing.
• Demonstrate professionalism and clarity in all interactions, effectively engaging with carriers, internal Client Executives, and external customers. Foster strong relationships through active listening, precise communication, and a service-oriented approach. Adapt communication style to suit diverse audiences, ensuring transparency and understanding in all claim-related discussions. Maintain a collaborative and solution-focused mindset to facilitate seamless coordination and efficient claims processing.

Benefits

• The pay range provided above is made in good faith and based on our lowest and highest annual salary or hourly rate paid for the role and takes into account years of experience required, geography, and/or budget for this role.

What This Job Offers

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