Customer Care Representative Sr. - Claims

Reliance Matrix•Arizona, AZ

39d•$19 - $26•Hybrid

About The Position

The Customer Care Representative Sr. is responsible for all aspects of customer experience and plays a vital role in ensuring that claims examiners can focus on their core responsibilities by handling communication, documentation, and routine inquiries efficiently. The ideal candidate will display a high level of compassion on a daily basis showing empathy, sympathy, and developed coping skills to maintain professionalism in every situation over the phone. Duties and Responsibilities: Providing Claimant Details: Provides detailed information to claimants regarding short-term disability, insured or self-insured claims, and statutory claims, as well as their concurrent leave claims. Managing Inbound Calls: Handles inbound calls from clients and claimants, addressing inquiries and resolving issues related to claims and leave processes. Performing Outbound Tasks: Performs outbound voice work and tasks related to selected clients and claimants, ensuring timely communication and follow-up. Accurate Documentation: Accurately files and documents client and claimant information into the applicable system, ensuring that claims examiners have up-to-date and precise detail/data to work with. Answering Claims Questions: Answers routine claims questions and provide information specific to the intake process and reporting time, helping to streamline the workflow for claim management. Technical Issue Resolution: Resolves routine administrative technical issues for applicable source systems, which supports the smooth operation of claims processing. Maintaining Confidentiality: By adhering to HIPAA rules and maintaining a high level of confidentiality, ensures that sensitive claimant information is protected, which is crucial in claims. Supporting Integrated Claims: Provides direct support to claimants, assists with various tasks and ensuring that claimants receive the necessary information and assistance for 1st call resolutions.

Requirements

GED or High School Diploma
2 - 3 years of call center experience or equivalent customer service experience required
Exceptional interpersonal communication skills and the ability to work with a diverse workforce.
Experience using web-based programs
High Speed home internet installed for Remote/Teleworker
Customer Service Skills: Polite, friendly, and helpful demeanor to provide exceptional service.
Communication Skills: Effective verbal and written communication to interact with claimants and team members.
Empathy and Compassion: Ability to show empathy and compassion, understanding the claimant's situation and providing support.
Attention to Detail: Strong attention to detail to accurately document information and manage claims.
Technical Proficiency: Basic technical knowledge of computer functions and proficiency in MS Office (Word, Excel, Outlook) and web-based programs.
Multitasking: Ability to handle multiple tasks simultaneously, such as typing and talking, while maintaining accuracy.
Problem-Solving: Strong decision-making skills and sound judgment to resolve issues and answer inquiries.
Confidentiality: Ability to handle confidential information with discretion and adhere to HIPAA rules.
Patience and Understanding: Proven patience and understanding to manage stressful situations and difficult claimants.
Organizational Skills: Ability to stay organized and manage time effectively in a fast-paced environment.
Adaptability: Flexibility to adapt to different working environments and schedules, including holidays and various shifts.
Interpersonal Skills: Exceptional interpersonal communication skills to work with a diverse workforce and collaborate with team members.
Self-Motivation: Ability to work independently, stay focused, and maintain discipline in a remote work setting.
Active Listening: Strong active listening skills to understand claimant needs and provide appropriate responses.
Employees are required to have sufficient visual acuity to perform activities such as preparing and analyzing data and figures; transcribing notes; viewing a computer terminal and extensive reading.
Employees are required to have sufficient hearing to understand verbal instruction and answer telephones.

Nice To Haves

Ability to Travel: None

Responsibilities

Providing Claimant Details: Provides detailed information to claimants regarding short-term disability, insured or self-insured claims, and statutory claims, as well as their concurrent leave claims.
Managing Inbound Calls: Handles inbound calls from clients and claimants, addressing inquiries and resolving issues related to claims and leave processes.
Performing Outbound Tasks: Performs outbound voice work and tasks related to selected clients and claimants, ensuring timely communication and follow-up.
Accurate Documentation: Accurately files and documents client and claimant information into the applicable system, ensuring that claims examiners have up-to-date and precise detail/data to work with.
Answering Claims Questions: Answers routine claims questions and provide information specific to the intake process and reporting time, helping to streamline the workflow for claim management.
Technical Issue Resolution: Resolves routine administrative technical issues for applicable source systems, which supports the smooth operation of claims processing.
Maintaining Confidentiality: By adhering to HIPAA rules and maintaining a high level of confidentiality, ensures that sensitive claimant information is protected, which is crucial in claims.
Supporting Integrated Claims: Provides direct support to claimants, assists with various tasks and ensuring that claimants receive the necessary information and assistance for 1st call resolutions.
Other duties as assigned

Benefits

An annual performance bonus for all team members
Generous 401(k) company match that is immediately vested
A choice of three medical plans (that include prescription drug coverage) to suit your unique needs. For High Deductible Health Plan enrollees, a company contribution to your Health Savings Account
Multiple options for dental and vision coverage
Company provided Life & Disability Insurance to ensure financial protection when you need it most
Family friendly benefits including Paid Parental Leave & Adoption Assistance
Hybrid work arrangements for eligible roles
Tuition Reimbursement and Continuing Professional Education
Paid Time Off – new hires start with at least 20 days of PTO per year in addition to nine company paid holidays. As you grow with us, your PTO may increase based on your level within the company and years of service.
Volunteer days, community partnerships, and Employee Assistance Program
Ability to connect with colleagues around the country through our Employee Resource Group program