Claims Customer Service Representative

Insurance Administrative Solutions, L.l.c.; Clearwater (FL); On-site; USD 36,000 - 48,000; Full time

Job summary

Integrity, LLC is hiring for a customer service-oriented role in the insurance sector. The position focuses on interpreting benefits, handling claims information, and maintaining clear audit-ready documentation.

Candidates should have a high school diploma or GED and strong communication skills to assist policyholders, agents, and providers. The role emphasizes accurate data entry, timely call handling, and adherence to procedures across cross-functional teams, with a commitment to professional,

Qualifications

• Requires a high school diploma or GED.
• Proven ability to handle high-volume calls with courtesy and professionalism.
• Strong communication and documentation skills are essential.
• Proficiency with Microsoft Office products preferred.
• Ability to multi-task and manage time effectively.

Responsibilities

• Receive, organize and use information regarding benefits, contracts, and policy decisions to provide prompt customer service.
• Interpret contract benefits to policyholders, agents, and providers.
• Provide claim status updates to policyholders or providers.
• Prepare and send refund request letters and follow up as necessary.
• Produce correspondence to customers and maintain accurate records.
• Adhere to company policies when handling calls and data.

Skills

Phone skills

Active listening

Microsoft Office

Communication

Documentation

Time management

Education

High School Diploma/GED

Tools

Microsoft Office

Job description

Job Summary

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.

Primary Responsibilities

• 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.

Primary Skills and Requirements

• 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.
• Familiarity with Microsoft Office products.
• 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.

About Integrity

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. Why? Because we put our people first! At Integrity, you can start a new career path at company you'll love, and we'll love you back. We're proud of the work we do and the culture we've built, where we celebrate your hard work and support you daily. Joining us means being part of a hyper-growth company with tons of professional opportunities for you to accelerate your career. Integrity offers our people a competitive compensation package, including benefits that make work more fun and give you and your family peace of mind. Headquartered in Dallas, Texas, Integrity is committed to meeting Americans wherever they are - in person, over the phone or online. Integrity's employees support hundreds of thousands of independent agents who serve the needs of millions of clients nationwide. For more information, visit Integrity.com. Integrity, LLC is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, national origin, disability, veteran status, or any other characteristic protected by federal, state, or local law. In addition, Integrity, LLC will provide reasonable accommodations for qualified individuals with disabilities.

Please note that all official communications from Integrity will come from @integrity.com or Workday domains. Founded in 2006, Integrity develops and distributes life and health insurance products and wealth products with carrier partners and markets these products through our vast distribution network. Our omnichannel platform helps provide life and health insurance and wealth management services to Americans to fit their unique needs. Wherever you are in life, the future can be a leap of faith.