Claims Customer Service Representative

About the Role

Integrity is one of the nation’s leading independent distributors of life, health and wealth insurance products. With a strong insurtech focus, we embrace a broad and innovative approach to serving agents and clients alike. Integrity is driven by a singular purpose: to help people protect their life, health and wealth so they can prepare for the good days ahead. Integrity offers you the opportunity to start a career in a family-like environment that is rewarding and cutting edge.

Key Responsibilities

• Receive, organize and make daily use of information regarding benefits, contract coverage, and policy decisions to provide prompt, courteous customer service, which meets or exceeds service standards.
• Interpret contract benefits in accordance with specific claims processing guidelines.
• Interpret contract benefits accurately to policyholder, agents, and providers.
• Provide claim status to policyholders or providers.
• Send out refund request letters and follow-up as necessary.
• Produce correspondence to customers.
• Answer calls as required by company policy in a helpful, professional, timely manner.
• Place outgoing calls as needed to provide or obtain information.
• Document (written/on-line) all calls while in progress.
• Transfer calls to employees in other departments as required to meet customer needs.
• Fully document policy file or imaging system with all related material so as to leave a clear and concise audit trail.
• Actively participate in cross training and group training sessions to maximize team efficiency and maintain or exceed service standards.
• Communicate problems identified relevant to the claims processing system to the appropriate people.
• Maintain external contacts with policyholders, providers of service, agents, attorneys and other carriers as well as internal contacts with peers, management, and other support areas with a positive and professional approach.
• Communicate openly with Supervisor, Team Lead and other team members to ensure accurate responses and avoid duplication of efforts.

Requirements & Tech Stack

• Familiarity with Microsoft Office products.

Qualifications

• A high school diploma or GED equivalent.
• Insurance background preferred.
• 0-2 years of proven customer support experience; prior call center experience preferred.
• Strong phone contact handling skills and active listening.
• Ability to adapt and respond to different types of people and tasks.
• Excellent communication and documentation skills.
• Ability to multi-task, prioritize, and manage time effectively and efficiently.
• Reliable transportation and the ability to be punctual and dependable.
• May have agent license but no active appointments.