Claim Specialist L1

Base Pay Range:

$18.50 per hour

Position Summary

The Claims Specialist (Level 1) is responsible for accurately and efficiently processing the intake of new claims requests, while providing outstanding customer service to contract holders, dealers, and repair facilities. This role requires strong attention to detail, adherence to company guidelines, and the ability to manage multiple priorities in a fast-paced call center environment. The Claims Specialist ensures claims are set up accurately, customers receive timely support, and all work aligns with company quality and compliance standards.

As a Claims Specialist, your essential job functions will include the following:

Key Responsibilities

• Process standard claims accurately and within SLA
• Maintain detailed claim documentation, photos, and communication logs
• Provide high-quality customer service to contract holders and repair facilities
• Accurately enter and update customer information, interactions, and case details in applicable CRM
• Collaborate effectively with other teams’ members, other departments as well to coordinate customer support efforts and resolve issues
• Achieve call, QA, and attendance metrics
• Follow established workflows, and escalation processes
• Handle and resolve customer complaints in a professional and timely manner.
• Develop and maintain a thorough understanding of the company's products, services, policies, and procedures.

Performance Standards

• Process and complete claims within 7-10 days, ensuring accuracy, efficiency, and compliance with company policies and regulatory requirements.
• QA Score: >85% on the quarterly Quality Assurance scorecard.
• Audit Errors: <2%
• Attendance: Meets department standards
• Adherence% >80%

Position Requirements

• Minimum 1-2 years of experience in customer service and/ or claims processing, preferably within a call center environment.
• High School Diploma required; Associate or bachelor’s degree preferred.
• Proficiency in using Salesforce and Microsoft Office Suite; Outlook, Word, Excel.
• Ability to efficiently navigate multiple computer systems while assisting customers.
• Excellent verbal and written communication skills.
• Proven ability to convey complex information clearly, accurately, and concisely.
• Strong commitment to providing exceptional customer experiences.
• Demonstrated ability to handle inquiries, issues, and complaints with professionalism and care.
• Strong time management and multitasking capabilities in a fast-paced environment.
• Effective analytical and problem-solving skills to identify and resolve issues efficiently.
• High level of accuracy and attention to detail in processing claims and documentation.
• Flexible and adaptable to change; able to learn new systems and processes quickly.
• Ability to collaborate effectively with team members and cross-functional departments.

Competencies Required

• Customer Focus & Empathy
• Communication & Collaboration
• Attention to Detail & Accuracy
• Critical Thinking & Decision-Making
• Adaptability & Learning Agility
• Results Orientation & Accountability
• Time Management & Prioritization
• Conflict Resolution & Influence

Physical Job Requirements

• Sit for long periods of time.
• Continuous viewing from and inputting data to a computer screen.