Customer Care Representative Sr Claims

Position: Customer Care Representative Sr. - Claims
Job Responsibilities and Requirements KEY RESPONSIBILITIES
* other duties as assigned
* The Customer Care Representative Sr. is responsible for all aspects of customer experience and plays a vital role in ensuring that claims examiners can focus on their core responsibilities by handling communication, documentation, and routine inquiries efficiently. The ideal candidate will display a high level of compassion on a daily basis showing empathy, sympathy, and developed coping skills to maintain professionalism in every situation over the phone.

Duties and Responsibilities:

Providing Claimant Details:
Provides detailed information to claimants regarding short-term disability, insured or self-insured claims, and statutory claims, as well as their concurrent leave claims.

Managing Inbound Calls:
Handles inbound calls from clients and claimants, addressing inquiries and resolving issues related to claims and leave processes.

Performing Outbound Tasks:
Performs outbound voice work and tasks related to selected clients and claimants, ensuring timely communication and follow-up.

Accurate Documentation:
Accurately files and documents client and claimant information into the applicable system, ensuring that claims examiners have up-to-date and precise detail/data to work with.

Answering Claims Questions:
Answers routine claims questions and provide information specific to the intake process and reporting time, helping to streamline the workflow for claim management.

Technical Issue Resolution:
Resolves routine administrative technical issues for applicable source systems, which supports the smooth operation of claims processing.

Maintaining Confidentiality:
By adhering to HIPAA rules and maintaining a high level of confidentiality, ensures that sensitive claimant information is protected, which is crucial in claims.

Supporting Integrated Claims:
Provides direct support to claimants, assists with various tasks and ensuring that claimants receive the necessary information and assistance for 1st call resolutions.

Work Environment Reliance Matrix ’s Customer Care Center operates 24 hours per day/7-days per week. We offer a variety of schedules due to this scope of coverage.

A Customer Care Representative Sr. must be available to work a scheduled shift between the core business hours;
Mon-Fri 4am to 8pm Arizona time, and open to working some Holidays.

Customer Care Representative Sr. must be willing and able to work sitting in one place taking calls and speaking for the entirety of their scheduled shift (excluding scheduled breaks and lunches).Customer Care Representative Sr. must be willing and able to work in a fast-paced, team-oriented, dynamic inbound/outbound call center.

Customer Care Representative Sr. must have predictable and reliable attendance and adherence to their daily and weekly assigned schedule.

REQUIRED KNOWLEDGE, SKILLS, ABILITIES, COMPETENCIES, AND/OR RELATED EXPERIENCE
* or equivalent experience gained from any combination of formal education, on-the-job training, and/or work and life experience
* Education, Qualifications and

Experience:

GED or High School Diploma2 - 3 years of call center experience or equivalent customer service experience required

Exceptional interpersonal communication skills and the ability to work with a diverse workforce.

Experience using web-based programs

High Speed home internet installed for Remote/Teleworker
* Key

Competencies:

Customer Service

Skills:

Polite, friendly, and helpful demeanor to provide exceptional service.

Communication

Skills:

Effective verbal and written communication to interact with claimants and team members.

Empathy and Compassion :
Ability to show empathy and compassion, understanding the claimant's situation and providing support.

Attention to Detail:
Strong attention to detail to accurately document information and manage claims.

Technical Proficiency:
Basic technical knowledge of computer functions and proficiency in MS Office (Word, Excel, Outlook) and web-based programs.

Multitasking:
Ability to handle multiple tasks simultaneously, such as typing and talking, while maintaining accuracy.

Problem-Solving:
Strong decision-making skills and sound judgment to resolve issues and answer inquiries.

Confidentiality:
Ability to handle confidential information with discretion and adhere to HIPAA rules.

Patience and Understanding :
Proven patience and understanding to manage stressful situations and difficult claimants.

Organizational

Skills:

Ability to stay organized and manage time effectively in a…