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About the role
Key responsibilities & impact- Primarily responsible for evaluating and adjudicating claim exception requests in adherence to established work instructions.
- Periodically responsible for adjudicating higher-risk exceptions not governed by established work instructions but supported through broader policies and agreements.
- Effectively track, log, and monitor claims you are working on.
- Navigate, prioritize, and execute client assignments in a fast-paced environment.
- Proven ability to monitor, identify, and flag emerging risk trends as necessary.
- Excellent verbal and written communication skills with internal and external partners.
- Maintain confidentiality of information related to customers, clients, and/or associates.
- Function as a resource to team members by answering and/or resolving policy questions, policy terms, program procedures, cancellation status inquiries, etc.
- Maintain accurate and proficient knowledge of products, policy terms and coverages, and program procedures.
- Research and review exception decisions to ensure validity and accuracy in accordance with program enrollment.
- Strong organizational skills to navigate ambiguity.
- Consistently achieve established team quality, productivity, and/or performance goals.
- Demonstrate willingness to perform additional tasks to support team initiatives as needed.
Requirements
What you’ll need- Possess or be willing to gain a valid Insurance License.
- Possess or be willing to gain a valid Home State Property & Casualty License.
- General proficiency with Microsoft Office tools.
- Willingness to work nights and/or weekend shifts.
Benefits
Comp & perks- Health insurance
- Flexible work arrangements
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
claim adjudicationrisk trend identificationexception request evaluationpolicy researchprogram procedure knowledge
Soft Skills
communication skillsorganizational skillsteam collaborationproblem-solvingadaptability
Certifications
Insurance LicenseHome State Property & Casualty License
