Remote Claims Representative

Remote, USA Full-time
We are looking for a detail-oriented, empathetic, and organized Remote Claims Representative to join our growing insurance team. In this role, you will be responsible for managing and processing insurance claims efficiently and professionally, ensuring that policyholders receive timely and accurate service. You will investigate, evaluate, and settle claims within established guidelines. This is an excellent opportunity for candidates who are self-motivated, thrive in a remote setting, and enjoy helping others navigate complex situations. Responsibilities: • Handle incoming claims from policyholders by phone, email, and online portals. • Investigate claim details through interviews, document reviews, and coordination with third parties. • Determine claim eligibility, coverage, and settlement amounts based on company policies and procedures. • Document all case activity and communications accurately within claims management systems. • Communicate clearly and empathetically with claimants regarding claim status, next steps, and required documentation. • Collaborate with adjusters, underwriters, legal staff, and outside vendors (e.g., appraisers, repair shops). • Ensure timely resolution of claims, maintaining compliance with internal deadlines and regulatory standards. • Escalate complex or high-risk claims to senior adjusters or claims management as appropriate. • Maintain confidentiality and adhere to all data privacy and compliance regulations (HIPAA, GDPR, etc.). Qualifications: • High school diploma or GED required. • 1+ years of experience. • Strong knowledge of insurance claim processes and terminology. • Excellent communication and active listening skills. • Comfortable working independently in a remote environment. • Tech-savvy with proficiency in claims software (e.g., Guidewire, Applied, Duck Creek) and Microsoft Office Suite. • High attention to detail and strong organizational skills. Apply tot his job
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