Claims Representative

The Call Center Claims Representative is responsible for managing a high volume portfolio of insurance claims primarily via telephone and digital channels , from initial report to final resolution. This vital role involves conducting thorough phone-based investigations, interpreting policy coverage, negotiating settlements , and ensuring claims are processed accurately, promptly, and in compliance with all company and regulatory standards. Success in this position requires exceptional analytical skills, adherence to call center metrics (e.g., AHT, Quality) , and superior customer service expertise.

Key Responsibilities

1. Claims Management & Investigation (Phone-Based)

• Handle Inbound/Outbound Calls: Professionally manage a high volume of calls to complete claims investigations, often navigating sensitive or complex situations over the phone.
• Determine Coverage & Liability: Accurately interpre...