Posted 4 days ago
Claims Representative
AI Summary
Processes non-contestable insurance claims transactions, including moderately complex cases across multiple products, ensuring data integrity and resolving escalated issues.
About this role
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Job Purpose
The Claims Representative independently processes non-contestable claim transactions including those which are moderately complex. This includes transactions for multiple products and business functions. Ensures all information is in “good order” for processing. This includes resolution and recovery of escalated requests and issues.
Essential Job Duties & Responsibilities
Independently processes a range of transactions including those which are moderately complex using documented procedures and multiple software applications.
Handles multiple processes/functions within the team.
Identifies, investigates and evaluates questionable transactions. Researches policy transactions and history as required.
Communicates with internal associates and external customers or agents regarding outstanding requirements, or transaction issues and problems. Resolves escalated calls and issues.
Documents status of transactions and contacts received and initiated.
Other Duties
Must meet departmental production and quality standards related to product or level. (i.e. case/transaction handling time, gain/loss transactions, adherence to documentation/verification standards, etc.)
May assist in training less experienced associates or quality check other associates’ work.
Other duties as assigned.
Knowledge, Skills & Abilities
Knowledge of Jackson’s product lines, claims process and organizational structure.
Good verbal and written communication skills to interact professionally with coworkers, management and external customers.
Ability to communicate and interpret moderately complex issues and requests.
Ability to navigate and utilize multiple software and mainframe computer applications.
Ability to work independently and in a team environment.
Ability to effectively manage the demands of a high volume, image-based work environment.
Ability to assist others by providing on-the-job training.
Education and Experience Required
High School diploma or equivalent (G.E.D.).
0-1 years work experience.
Certifications, Licenses, Registrations
Relevant LOMA classes preferred.
Jackson is proud to be an equal opportunity workplace. The Company subscribes to and endorses federal and state laws and regulations relating to equal employment opportunity for all persons without regard to race, color, religion, gender, age, national origin, legally-recognized disability, marital status, legally-protected medical condition, citizenship, ancestry, height, weight, sexual orientation, veteran status, or any other factor not related to the needs of the job. The Company is committed to a policy of equal opportunity. Company facilities and campuses are tobacco-free environments.
Skills
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