Customer Support

• Performs tasks assigned by Claims Specialist to gather information (via phone, fax, or e-mail) that is necessary for claim adjudication
• Reviews new claims for eligibility requirements, creates and sends claimant letters, and communicates with claimants, brokers, plan administrators, or physicians to obtain information necessary to triage claims to a Claims Specialist
• Completes requests assigned by Claims Specialist to obtain medical documentation and coordinates payment for records when necessary
• Ability to independently manage worklist and complete tasks within established turn-around time expectations
• Ability to communicate effectively across multiple channels, including phone, e-mail, and letter
• The ability to follow outlined steps in a checklist or workflow with a high degree of accuracy and consistency
• The ability to communicate clearly with outside partners such as physicians’ offices and other vendors
• Ability to accurately summarize large quantities of medical information and data into actionable, usable data summaries
• Ability to make basic claims decisions based on the information available to them and adherence to established workflows
• Process improvement mindset – ability to identify trends and suggest process improvements to deliver an improved level of customer experience
• Strong communication skills – both written and verbal – including the ability to anticipate and address next questions/root cause
• Ability to communicate effectively in a customer-centric and professional demeanor
• Willingness to accept coaching, and ability to provide coaching and feedback to peers, teammates, and leaders
• Demonstrated ability to use sound judgement and discretion regarding confidential information
• Participates and contributes to team meetings or special tasks and assignments and brings innovative ideas and a continuous improvement mindset to the department
• Consistently supports and promotes change management and/or departmental/enterprise initiatives within assigned area(s) of responsibility
• Fosters strong partnerships and collaborates with key internal areas, such as Claims, Compliance/Legal, Support Services, Intake/Admin, etc.
• Job performance must meet department standards for work prioritization, productivity, quality and timeliness
• Identifies, understands and ensures that actions, behaviors and decisions are consistent with the department, division and Pacific Life Mission & Vision
• Perform other duties as assigned

Claims Support Specialist II

Internal Customer Support Coordinator

Customer Support Representative

Application Support Specialist

Customer Experience Team Lead

Customer Experience Manager – Business Banking