Bilingual Claims Care Representative I

Job Summary

The Claims Care Representative I provides excellent customer service and support to policyholders to assist in the initial claim setup. This position reports to the Claims Care Team Lead and makes and receives calls from policyholders, providing guidance through the steps of reporting a new claim. The Claims Care Representative I ensures all necessary information is accurately recorded, details are documented, and initial expectations in the claims process are provided, including explaining required documents.

Job Functions

• Assists and supports adjusters and management with administrative tasks included but not limited to:
  • Mailing checks and letters
  • Compiling paperwork
  • Providing necessary forms required on a claim
  • Acquiring and uploading declaration page to claim file
  • Completing claims reported to third party vendor assigning claims numbers to the files
  • Uploading documents received on policyholder’s claims to claim file; notifying assigned adjusters of information received
• Serves as the first point of contact for policyholders reporting a new claim
• Sets expectations and next steps to policyholder; explains documentation and other information needed for claim process
• Creates new claim reports by collecting detailed information about a loss and verifying policyholder’s contact information
• Demonstrates empathy and sensitivity when dealing with policyholders who may be experiencing stress or loss, helping to build trust and maintain a positive customer relationship
• Accurately enters loss information into the claims system and generates a claim number
• Other duties as assigned

Qualifications

• Education: High School diploma or equivalent
• Experience: 0-2 years of related experience preferred, but not required
• Must have strong computer skills with ability to navigate Microsoft Office Suite
• Travel as needed
• Ability to communicate effectively and efficiently via phone, email, and person to person
• Capability of gathering facts accurately, analyzing causes, evaluating alternate solutions, and arriving at sound conclusions on action to be taken
• Ability to manage multiple and/or conflicting responsibilities
• Great attention to detail, organizational skills, and time management
• Good sense of urgency and follow up
• Ability to handle stressful situations
• Ability to work in a team environment
• Bilingual in English and Spanish required

Physical Demands

• Must be able to remain in a stationary position 75% of the time
• Will be constantly operating a computer and other office productivity machinery, such as a telephone, calculator, copy machine, and computer printer
• Will be communicating via phone, Teams, and Zoom
• Must be able to exchange accurate information at all times
• Must be able to identify and assess claim status and determine appropriate process
• Primarily works in a state-of-the-art indoor temperature controlled, sealed window office environment, while maintaining a hybrid schedule