Summary of Position
The Claims Associate Team Lead is responsible for oversight of the Claims Associate Team providing support to direct reports while assisting insurance claims adjusters by fielding phone calls and performing clerical tasks related to the processing of insurance claims. They will work with claims associates to review processes, implement training, and monitor daily workflow to ensure timely and accurate processing of claims.
Essential Job Requirements
Claims Call Center
- Handle inbound calls to provide claims support to insureds and claimants to include claims status, payment history and general claims questions.
- Responsible for monitoring the department call queues to ensure proper staffing.
- Manage inbound and outbound calls to ensure faster response time within the team.
- Answer questions from the Claims Associate Team on escalated calls related to the claim.
- Guide the Claims Associate Team through the various claims processes and set expectations.
- Weekly team meetings to review metrics and address deficiencies.
- Responsible for implementing training for all new and existing team members.
Claims Administration
- Ensure that all team members are trained in necessary systems such as:
- Evolve
- Samba
- ISO
- Claimpix, etc.
- Manage call volume and daily staffing to ensure efficiency.
- Navigate various claims systems to provide claims status and/or customer service as needed.
- Attend meetings or conference calls with claims adjusters, clients or management to provide updates on claims status and discuss claim-related issues
- Accurate documentation of the call in the claims system for compliance
- Identify and escalate issues or concerns related to claims status or customer service to the appropriate parties for further investigation or resolution.
- Work with the Claims Manager to write and implement new processes.
General
- Maintains job knowledge through intermittent training/learning and incorporates new information into daily tasks
- Meet expectations for attendance and punctuality
- Meet expectations for job performance and meeting company goals
- Work overtime as required
- Present a professional and helpful appearance
- Perform other duties as may be assigned
Required Skills
- Experience in claims practices and procedures
- Ability to remain calm and courteous under pressure and navigate tense situation especially during busy hours
- Proficiency with technology, especially computers, software application, and phone systems
- Strong understanding of company products, policies and services
- Strong verbal communication skills including active listening; uses written communication skills to record inquiry information and policy activity
- Strong analytical skills, ability to pay attention to details
- Ability to work independently and to carry out assignments to completion within the parameters of instructions given, prescribed routines and standard accepted underwriting practices
- Strong interpersonal skills
- Positive attitude
- Able to work in a fast paced and team-oriented environment
Required Education
- High school graduate, college level courses with an emphasis on business or marketing studies helpful
Required Experience
- 3-4 years experience in an insurance office
- 2-3 recent years experience with claims
Physical Requirements
- May be sitting for up to 2 hours straight with short break
- Constant keyboard entry for up to 2 hours with short break
Mental Requirements
- Must be able to do simple math
- Must have the ability to identify a problem and review related information to develop and evaluate options and implement solutions