Claims Processor I (Remote)

Remote: 
Full Remote
Contract: 
Work from: 

Offer summary

Qualifications:

High school diploma or equivalent required., Proficiency in Microsoft Office, particularly Word and Excel., Strong customer service and communication skills, especially over the phone., Ability to work well in a team and demonstrate good decision-making skills..

Key responsabilities:

  • Review and verify claim submissions and forms for accuracy.
  • Provide customer service for claim inquiries and handle FedEx requests.
  • Index incoming documents and manage returned correspondence.
  • Assist in processing claims during high volume periods and verify claim checks for accuracy.

California FAIR Plan Association logo
California FAIR Plan Association Insurance SME https://www.cfpnet.com/
51 - 200 Employees
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Job description

POSITION SUMMARY
The Claims Processor I is responsible for reviewing claim submissions, obtaining, and verifying claim information, reviewing claim forms for accuracy, and obtaining missing information as necessary. This person will be responsible for reviewing claim payments in legacy. In addition, the Claims Processor I provides customer service to callers in relation to their claim and/or inquiries. They will work under the close direction of senior personnel in the Claims and Operations departments reporting to the Claims Admin Supervisor.


PRINCIPAL DUTIES & RESPONSIBILITIES
•    File new losses (claims).
•    Verify new first notice of loss (FNOL) in duck creek. 
•    Enter claims in assignment log sheet.
•    Provide excellent customer service on all telephone calls & inquiries.
•    Handle FedEx requests.
•    Copy claim files for compliance or Counsel.
•    Produce copy of insureds complete policies (upon request).
•    Obtain recorded statements or transcribed recordings for download to file.
•    Index incoming documents from the claims queue, such as adjuster reports, emails, and correspondences and other OnBase queues.
•    Handle returned/undeliverable correspondence from post office.
•    During high volume of incoming claims during a catastrophe, assist in calculating and issuing FRV checks. 
•    Verify /Proofread claim checks issued by examiners for accuracy against documentation in claim file and return check to examiner if corrections are needed.
•    Obtain check signer approval for any checks over $250k.
•    Issue general and legal expense payments.
•    Apply subrogation and refund payments to claims.
•    Enter voids requests (as needed).
•    Handle direct requests from department staff.

ADDITIONAL DUTIES & RESPONSIBILITIES 
Claims Processor II:
•    Provides claim assignment support and back up for Claims Admin Supervisor.
•    Facilitates training/onboarding for new Claims Processors.                                                                                                                                                                              
EDUCATION & EXPERIENCE
•    High school diploma or its equivalent. 
•    Microsoft Office knowledge (Word and Excel).
•    Exhibit good customer service and communication skills with emphasis on phone skills.
•    Demonstrate good interpersonal skills (both internal and external) and work well in a team environment.
•    Exercise good decision making and judgment.
•    Perform tasks with minimal supervision.


ADDITIONAL REQUIREMENTS (PRIOR EXPERIENCE)
Claims Processor I:  Prior experience with admin or equivalent duties (2 years).            


Compensation$60,000-$65,000

Required profile

Experience

Industry :
Insurance
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Other Skills

  • Customer Service
  • Detail Oriented
  • Microsoft Office
  • Decision Making
  • Teamwork
  • Communication

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