Claims Information Service Rep

The Claims Information Service Representative will handle inbound and/or outbound calls from policyholders and injured workers regarding workers compensation claim status regarding payments, medical treatment authorization, and provide one call resolution to the caller.

Hours

Monday to Friday (8:45AM- 5PM)

Hybrid opportunity once training is complete (3 days in office, 2 days remote).

Essential Duties and Responsibilities: Essential functions of this job are listed below in order of priority. Reasonable accommodations may be made to enable individuals to perform the essential duties. Regular and predictable onsite attendance is an essential function of the job.

• Answer calls from internal and external customers using excellent customer service skills.
• Field and manage calls appropriately with one call resolution and/or to the respective department.
• Utilize available tools and databases to provide accurate information to callers.
• Process incoming First Reports of accident via telephone, email and fax accurately and expeditiously.
• Actively listen to and transfer calls when appropriate to achieve a first call resolution.
• Accurately complete authorization requests and escalate requests to appropriate personnel when needed.
• Complete callbacks in a timely manner, documenting calls and results in computer correspondence.
• Navigate multiple computer systems simultaneously to access and document appropriate information.
• Provide support and back up to other areas in workers’ compensation claims, complete other tasks as needed.
  
  

Required Qualifications: Knowledge, skills & abilities, experience, minimum & desired education, certification and/or license requirements.

• Previous inbound telephone customer service experience in a call center environment preferred.
• Ability to problem solve and work independently.
• Accuracy and attention to detail.
• Ability to provide excellent customer service while demonstrating impeccable phone etiquette.
• Excellent verbal and written communication skills.
• Strong data entry skills.
• Reliability.
• HS diploma or GED equivalent
  
  

Preferred Qualifications

• Use of Claim Center, Policy Center, InContact a plus.
• Bilingual English/Spanish is preferred.
• Insurance experience and knowledge of medical terminology a plus.
  
  

Compensation: Salary is commensurate with experience and credentials.

Pay Range: $40,864-$47,423

Eligible full-time employees receive a competitive Total Rewards package, including but not limited to a 401(k) with employer match up to 8% and additional service-based contributions, Health, Dental, and Vision insurance, Life and Disability coverage, generous PTO, Paid Sick Leave, and paid parental leave in addition to state-mandated leave. Employees may also be eligible for discretionary bonuses.

Legal Disclaimer: NJM is proud to be an equal opportunity employer. We are committed to attracting, retaining and promoting a diverse and inclusive workforce that is fully representative of the diversity that exists in the communities in which we do business.