Claims Call Center

fulcrumdigital; Pune District; On-site; INR 350,000 - 480,000; Full time

Job summary

Fulcrum Digital in Pune is seeking an experienced Claims Call Center Representative with 3+ years in insurance claims or customer service. The role focuses on FNOL, claim status updates, verification of policy details, and coordinating with internal teams to resolve queries.

You'll handle inbound calls about P&C claims, explain procedures, document information accurately, meet SLAs, and maintain compliant, empathetic customer interactions while escalating complex issues when needed.

Qualifications

• 3+ years of experience in insurance claims or claims call center operations.
• Experience with Property & Casualty (P&C) insurance preferred.
• Strong verbal and written communication.
• Ability to handle high call volumes with empathy.
• Adept at documenting information accurately.

Responsibilities

• Handle inbound customer calls related to insurance claims, FNOL, claim status, coverage, payments, and settlements.
• Accurately capture and document claim information during the FNOL process.
• Verify policy details, coverage, limits, deductibles, and claim status.
• Explain claims procedures, required documentation, and next steps to customers.
• Provide timely and accurate updates on claim progress.
• Address customer questions and resolve routine claim-related issues during the call.
• Coordinate with claims adjusters, brokers, agents, payment teams, and internal departments to resolve customer queries.
• Follow up on outstanding claim information and documentation when required.
• Identify and elevate complex claims, complaints, coverage issues, or service requests to the appropriate team.
• Maintain accurate customer, claim, and call records in the relevant systems.
• Ensure all interactions are handled within defined SLAs, quality standards, and compliance requirements.
• Handle sensitive customer situations professionally and demonstrate empathy during claim interactions.
• Identify recurring customer issues and provide feedback to improve claims processes and customer experience.
• Follow company policies, regulatory requirements, data privacy guidelines, and claims handling procedures.

Job description

Job Title: Claims Call Center Representative – P&C Insurance Experience 3+ years of experience in insurance claims, customer service, or claims call center operations. Experience in Property & Casualty (P&C) Insurance is preferred. Role Summary We are looking for an experienced Claims Call Center Representative to handle customer interactions related to Property & Casualty insurance claims. The role will be responsible for managing First Notice of Loss (FNOL), responding to claim-related inquiries, providing claim status updates, verifying policy information, and coordinating with internal claims teams to ensure timely and accurate resolution.

Key Responsibilities

• Handle inbound customer calls related to insurance claims, FNOL, claim status, coverage, payments, and settlements.
• Accurately capture and document claim information during the FNOL process.
• Verify policy details, coverage, limits, deductibles, and claim status.
• Explain claims procedures, required documentation, and next steps to customers.
• Provide timely and accurate updates on claim progress.
• Address customer questions and resolve routine claim-related issues during the call.
• Coordinate with claims adjusters, brokers, agents, payment teams, and internal departments to resolve customer queries.
• Follow up on outstanding claim information and documentation when required.
• Identify and elevate complex claims, complaints, coverage issues, or service requests to the appropriate team.
• Maintain accurate customer, claim, and call records in the relevant systems.
• Ensure all interactions are handled within defined SLAs, quality standards, and compliance requirements.
• Handle sensitive customer situations professionally and demonstrate empathy during claim interactions.
• Identify recurring customer issues and provide feedback to improve claims processes and customer experience.
• Follow company policies, regulatory requirements, data privacy guidelines, and claims handling procedures.

Required Skills

• Strong understanding of P&C insurance and claims processes.
• Experience handling customer calls in an insurance/claims environment.
• Strong verbal and written communication skills.
• Excellent customer service and active listening skills.
• Ability to handle difficult or escalated customer interactions professionally.
• Strong problem-solving and decision-making skills.
• Good attention to detail and accurate documentation skills.
• Ability to manage high call volumes and multiple customer requests.
• Ability to work effectively within a team and meet defined SLAs/KPIs.
• Good working knowledge of MS Office and claims/customer service applications.

Key Performance Areas

• Call quality and customer satisfaction.
• FNOL and claim information accuracy.
• First-call resolution and effective query handling.
• Adherence to SLAs and turnaround times.
• Documentation and data accuracy.
• Compliance with claims and customer service procedures.