Claims Representative Jobs

About The Position

Requirements

• High school diploma or GED.
• Up to 2 years of relevant experience in customer service, administrative support, insurance operations, or a related field.
• Proficiency in Microsoft Word, Excel, PowerPoint, and Access, with the ability to navigate multiple systems and accurately enter and maintain information.
• Strong organizational skills and attention to detail, including the ability to manage multiple priorities, maintain accurate records, and meet daily deadlines.
• Analytical and problem-solving skills, including the ability to review documentation, identify discrepancies, and resolve routine issues using established procedures and guidelines.
• Effective written, verbal, and telephone communication skills, a strong customer service focus, and the ability to collaborate with claimants, administrators, physicians, attorneys, and internal business partners.

Nice To Haves

• Associate's degree.
• 2 or more years of relevant experience in customer service, administrative support, insurance operations, or a related field.
• Familiarity with claims management systems, document imaging platforms, electronic workflows, or records management processes.
• Understanding of disability insurance, supplemental health insurance, or other group insurance products.

Responsibilities

• Process incoming mail, emails, faxes, and scanned documents, ensuring accurate indexing, routing, and organization in claims imaging and workflow systems.
• Establish and maintain new claims across Short Term Disability, Long Term Disability, Office Overhead Expense, Critical Illness, Hospital Indemnity, and Rabies insurance products, including accurate data entry, coding, and timely processing.
• Coordinate with third-party administrators and other stakeholders to obtain required claim forms, verify eligibility documentation, resolve missing information, and support complete and accurate claim submissions.
• Maintain claim forms, assignment records, departmental contact information, and correspondence; assist claims examiners with administrative requests and claims-related activities.
• Communicate professionally with members, claimants, administrators, and other stakeholders, address inquiries, and support timely resolution of routine claims-related issues.

Benefits

• Full package of employee benefits, with offerings that include leave programs, adoption assistance, and student loan repayment programs.
• Eligible for an annual discretionary bonus; may also be eligible to participate in an incentive program.