Claims Services Representative I | 100% Remote (WFH) Opportunity     

General Summary

The Claims Services Representative I will perform a variety of claim handling functions from new claim set up and non-medical bill payment to preparing and distributing various forms and correspondence. This position interacts with insureds, claims adjusters, attorneys, and outside vendors to gather, analyze and document complete and accurate data while providing an exceptional customer experience.

 

Essential Duties and Responsibilities

• Support the business in technical, administrative, and clerical tasks.
• Request information from providers, injured employees, and insureds via phone, email, fax, and mail.
• Research and identify requested information and follow up as needed.
• Processes work assignments timely while adhering to Service Level Agreement parameters established by company policies and procedures.
• Manage electronic mail inboxes related to new claims, existing claims, expedited requests, and document imaging.
• Handle inbound and outbound telephone calls to obtain pertinent medical and claim information.
• Perform mathematical calculations to process appropriate payments to claimants, providers, and third-party vendors.
• Establish and maintain ongoing professional communications with all customers, internal and external, ensuring satisfaction with company services.
• Maintain a high standard of accuracy and attention to details.
• Conduct business at all times with the highest standards of personal, professional, and ethical conduct.
• Complies with all policy, procedural, and jurisdictional statutes.
• Other duties as assigned.
• Claims Intake Focus:
• Complete and assist in the setup of new workers’ compensation claims.
• Claims Processing Focus:
• Responsible for creating and distributing claim forms and correspondence.

 

Requirements - Background and Experience/Expertise

• Proficient in the use and knowledge of MS Office software, including Word, Outlook, and Excel
• Familiar with general office procedures, methods, and equipment including computers, photocopiers, fax machines, and telephone systems.
• Can navigate multiple systems to achieve desired results.
• Maintain a high standard of accuracy and attention to details. Can conduct business efficiently and effectively over the telephone utilizing proper phone and computer etiquette.
• Demonstrated customer service experience.

 

Education

• Must have High School diploma or GED equivalent.

Work Environment:

• Remote: This role is remote, and only open to candidates currently located in the United States and able to work without sponsorship.
• It requires a suitable space that provides a private and quiet workplace.
• Expected Work Hours: Schedules are set to accommodate the requirements of the position and the needs of the organization and may be adjusted as needed.
• Travel: May be required to travel to off-site location(s) to attend meetings, as necessary 

Hourly Pay Rate: $21.00/hour or $22.00/ hour if bilingual in Spanish and a comprehensive benefits package, please follow the link to our benefits page for details! https://www.employers.com/careers/our-benefits-and-perks/

About EMPLOYERS

As a dynamic, fast-growing provider of workers' compensation insurance and services, we are seeking a goal-oriented individual willing to put their ideas to work! 

We offer a positive, challenging work environment, combined with an opportunity to build your career as you help us grow our business, in innovative and imaginative ways that are uniquely EMPLOYERS! 

Headquartered in Nevada, EMPLOYERS attributes its long-standing success to its most valuable resource, our employees across the United States.  EMPLOYERS is known for the quality service and expertise we provide to our clients, and the exemplary work environment we provide for our employees. 

We live and breathe our core values: Integrity, Customer Focus, Collaboration, Initiative, Accountability, Innovation, and Personal Fulfillment.  These are the pillars that support how we do business with our clients as well as how we treat each other! 

At EMPLOYERS, you’ll discover an energetic environment that inspires top achievement.  As “America’s small business insurance specialist”, we have the resources, a solid reputation and an expanding nationwide identity to enrich your work/life and enhance your career. #LI-Remote