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Customer Care Representative - Claims

Role overview

Qualifications

  • Strong customer service skills
  • Proven experience in providing quality customer service
  • Ability to communicate effectively in both verbal and written interactions
  • Proficient at maneuvering on a PC with working knowledge of MS Office (Word, Excel and Outlook)

Responsibilities

  • Answer inbound calls from clients and claimants across the country
  • Accurately file and document client/claimant specific information into the applicable system
  • Respond to client and claimant inquiries in a timely and efficient manner
  • Maintain and protect personal health information in accordance with HIPPA rules and regulations

Key facts

Hard skills

Other skills

  • Customer Service
  • Communication
  • Decision Making
  • Detail Oriented
  • Compassion
  • Empathy
  • Time Management
  • Multitasking
  • Organizational Skills
  • Microsoft Office
  • Active Listening
  • Social Skills
  • Reliability
  • Personal Integrity
  • Self-Motivation

About the company

Reliance Matrix logo

Reliance Matrix

Insurance

Reliance Matrix delivers employee benefits, absence management and workforce productivity solutions through the financial stability of a top-rated insurance carrier, the agility and innovative spirit of a Third Party Administrator (TPA), and the daily commitment of thousands of team members across America. Where larger competitors offer size, we inspire confidence and long term engagement through integration, reliability and dedication to providing customized solutions. Reliance Matrix innovates and provides technology-driven absence and benefit solutions that enable employees and employers to manage time away from work. We help employers attract and retain valuable human capital through thoughtful, inclusive benefit programs delivered with care. We bring top-tier regulatory knowledge and cutting edge technology to help optimize workforce productivity and compliance. We offer a seamless member experience customized to each individual’s need and event. We integrate our solutions and expertise with leading HR technologies to ensure accuracy, efficiency and a superior customer experience. We are a proud member of the global Tokio Marine Group, one of the oldest, largest and most respected insurance organizations in the world. In the business hierarchy, human capital is the most precious of assets. Reliance Matrix delivers comprehensive, integrated solutions and services to attract, protect and help optimize an employer’s work force in a changing, challenging world.

Company details

Company typeLarge
IndustryInsurance
Company size1001 - 5000

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Job description

Job Responsibilities and Requirements

The Customer Care Representative 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. This individual will treat every claimant with a high level of integrity demonstrating accountability; respectful and reliable. Willingness to help teammates while accepting other duties as assigned, as needed. Demonstrate a strong worth ethic, the ability to self-motivate and work well independently, while being focused and disciplined in a professional environment. Provide effective verbal and written communication skills timely while providing excellent customer service. Use judgment with a sense of urgency to make accurate decisions and utilizes available resources. Has the ability to multitask, remain organized and be detailed oriented, takes initiative and able to adapt to different working environments. This position will manage inbound calls for claimant related leaves and/or Intake applications, and perform outbound voice work tasks related to selected clients and claimants.


  • Answer inbound calls from clients and claimants across the country
  • Accurately file and document client/claimant specific information into the applicable system
  • Adhere to all department standards
  • Respond to client and claimant inquiries in a timely and efficient manner
  • Consistently deliver exceptional customer service. Measured by the results of our Quality Monitoring program
  • Ability to communicate effectively with all levels of management.
  • Demonstrate confidence, strong decision quality and sound judgment when assisting claimants.
  • Resolves routine administrative technical issues for applicable source systems
  • Answer related claims questions for applicable clients specific to the Intake process and reporting missed time
  • Responsible and accountable for maintaining and protecting personal health information. Must maintain a high level of confidentiality and abide by HIPPA rules and regulations
  • Reliable, regular, and predictable attendance to ensure appropriate staffing to handle call volume
  • All other duties as assigned

 Key Competencies:

  • Strong customer service skills: Polite, Friendly, and Helpful
  • Ability to type and talk
  • Proven patience and understanding
  • Active listening skills
  • Strong attention to detail
  • Demonstrated compassion
  • Ability to work independently and remotely
  • Ability to communicate effectively in both verbal and written interactions
  • Ability to handle confidential information with the utmost judgment and discretion
  • Exceptional interpersonal communication skills and the ability to work with a diverse workforce.
  • Proficient at maneuvering on a PC with working knowledge of MS Office (Word, Excel and Outlook).
  • Ability to manage and meet departmental deadlines and key performance indicators
  • Demonstrated ability in verbal and written skills, and reading comprehension.
  • Proven experience in providing quality customer service (preferably a call center)
  • Knowledge of medical terminology preferred
  • Experience using web based programs
  • High Speed home internet installed for Remote/Teleworker*

Work Environment

  • Reliance Matrix’s Customer Care Center operates 24 hours per day/7-days per week. We offer a variety of 
    schedules due to this scope of coverage.
  • A Customer Care Representative must be available to work a scheduled shift between the core business hours; Mon-Fri 4am to 8pm Arizona time, and open to working some Holidays. 
  • Customer Care Representative must be willing and able to work sitting in one place taking calls and speaking for the entirety of their scheduled shift (excluding scheduled breaks and lunches).
  • Customer Care Representative must be willing and able to work in a fast-paced, team oriented, dynamic inbound/outbound call center.
  • Customer Care Representative must have predictable and reliable attendance and adherence to their daily and weekly assigned schedule.

PHYSICAL REQUIREMENTS


When used in the description below, the following terms are defined as:

“Occasional”: done only from time to time, but necessary when it is performed

“Frequent”: regularly performed; generally an act that is required on a daily basis

“Continuous”: typically performed for the majority of an employee’s shift


Sitting for prolonged periods of time, extensive typing and otherwise using primarily the fingers rather than the entire hand.  Employee is required to have visual acuity sufficient to perform activities such as preparing and analyzing data and figures; transcribing notes; viewing a computer terminal and extensive reading. Employee is required to have hearing sufficient to understand verbal instruction and answer telephones.  Reliance Standard Life Insurance will provide qualified employees with a reasonable accommodation in accordance with applicable law.


The above description reflects the general details considered necessary to describe the principle responsibilities and functions of the job identified and shall not be construed as a detailed description of all the work requirements that may be inherent to this job.

The expected hiring range for this position is $18.00 hourly. This expected hiring range covers only base pay and excludes any other compensation components such as commissions or incentive awards. The successful candidate’s starting base pay will be based on several factors including work location, job-related skills, experience, qualifications, and market conditions. These ranges may be modified in the future.


Work location may be flexible if approved by the Company.


What We Offer

At Reliance Matrix, we believe that fostering an inclusive culture allows us to realize more of our potential. And we can’t do this without our most important asset—you.

That is why we offer a competitive pay package and a range of benefits to help team members thrive in their financial, physical, and mental wellbeing.  

Our 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

Our Values:

  • Integrity
  • Empowerment
  • Compassion
  • Collaboration
  • Fun

EEO Statement

Reliance Matrix is an equal opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, national origin, citizenship, age or disability, or any other classification or characteristic protected by federal or state law or regulation. We assure you that your opportunity for employment depends solely on your qualifications.

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Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
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