Overview

The Claims Service Representative plays a key role in supporting the Claims team as by assisting with the coordination of communication between clients, service staff and insurance carriers. He or she rapidly responds to questions asked by clients and internal teams, advising clients on reporting techniques and procedures, and managing claims through conclusion. Additionally, the Claims Service Representative supports the team’s Claims Advocates with claim status updates and reviews.

Responsibilities

CLAIMS

• Processes claim information from the client, makes appropriate policy verification and reports to the appropriate insurance carrier
• Instructs insured on gathering proper claim information needed for claim reporting and correct procedures for submitting claims
• Sets diaries to follow claim progress as needed and assigns to other team members appropriately
• Updates agency management system claim notes with adjuster information, open/closure notices and monitors and maintains paper and electronic filing systems
• Maintains a concern for timeliness and completeness when interacting with customers, agency teams and insurance carriers to minimize potential for error and omission claims
• Communicates claims concerns, large claims or potential problems to appropriate producer and refer to Claims Advocates as needed
• Updates clients regarding file status on First Party Automobile and Property Claims
• Obtains status reports from insurance carriers on individual claims and prepare for presentation to client
• Maintains knowledge of claim reporting criteria for carriers represented by agency
• Assists in developing, training and updating of internal claim procedures, programs, and processing
• Addresses and resolves client claim questions/problems
• Is familiar with and follow agency procedures

EXECUTION OF CLIENT SERVICE

• Supports Claims team members and other internal department members to flawlessly execute Assurance’s service strategy for each client, designed to create measurable value and efficiencies in their businesses
• Processes changes, as needed or requested by the client, checking for consistency and documenting in the appropriate system
• Builds personalized client relationships through demonstrated understanding of the service plan and multiple channels of communication such as phone, email and in-person meetings
• Leverages insurance knowledge and communication skills to explain coverage terms, program options and other items to clients as needed
• Works with internal departments to ensure cohesiveness and timeliness of service execution
• Manages time effectively to prioritize workload, client service requests and service parameters on business processes

DATA AND PROCESS INTEGRITY

• Maintains accurate and complete client data in agency management systems including policy detail, activities, attachments or anything in regards to claims
• Consistently achieves data integrity and meets activity timeliness, quality metrics and goals
• Follows processes and procedures in servicing workflow, maintaining appropriate and clear documentation of client and carrier conversations, taking appropriate action and following up as requested
• Utilizes internal resources for identified processes to ensure efficiency and consistency in execution

PEER RELATIONSHIPS

• Provides feedback and shares information at team meetings
• Participates in ongoing scheduled meetings with Claims team to discuss accounts, renewals, service needs, service platform, etc.
• Develops successful and effective working relationships with Producers, Account Executives, Account Managers, service team members, managers, carriers and members of other departments

• Communicates effectively with Claims team members and provides timely and complete information to allow them to effectively manage service execution

Qualifications

REQUIRED:

• Knowledge of software systems, to include excel

PREFERRED:

• BS/BA in Business, Insurance or related field
• Intermediate skill level in Microsoft Office Suite