Claims Processor I

Jobtailor; Town of Florida (NY); On-site; USD 42,000 - 62,000; Full time

Job summary

Jobtailor is seeking an Insurance Claims Processor to support clients by filing claims with carriers, reviewing coverage, and maintaining SOPs. You will complete outbound calls, determine coverage status, and document communications with carriers to ensure accurate settlements.

The role requires strong written and verbal communication, experience with AMS/Applied, and proficiency in Microsoft Office. Attention to detail, multitasking, and the ability to work independently or in a team in a

Qualifications

• Prior insurance, insurance claims, or insurance agency processing a plus.
• High School diploma required
• Associate or bachelor's degree preferred
• Strong written and oral communication skills
• Experience with Insurance Agency Management System (Applied or AMS)
• Experience with Microsoft Office Suite
• Excellent time management skills
• Detail oriented
• Technical learning with strong desire to learn and acquire new skills
• Ability to adapt to a changing environment and handle multiple priorities to meet deadlines
• Ability to multitask
• Ability to work independently as well as in a team environment

Responsibilities

• Complete outbound calls to insurance carriers to file claims on behalf of clients
• Participate in inter/intraoffice discussions and problem solving
• Complete timely review and entry of new losses
• Determine if coverage is in place and send documentation to insurance carriers
• Follow up with carriers to ensure proper documentation of acknowledgements, determinations and final settlements
• Review all determinations and discuss with carrier adjustors or TPAs
• Maintain SOPs for all claims processes
• Apply understanding of insurance policies and policy interpretation to assist clients and carriers with claim settlement
• Assist Account Service Managers, Producers, and Clients with claims questions or issues
• Escalate complex claim questions to VP Lender Services and Placement
• Complete claims reporting to Account Service Managers, Producers, Clients and Loan Protector Leadership
• Maintain an average productivity percentage of 70%

Skills

Strong written and oral communication

Time management

Multitasking

Team collaboration

Problem solving

Detail oriented

Education

High School diploma

Associate or bachelor's degree preferred

Tools

Applied

AMS

Microsoft Office Suite

Job description

• Complete outbound calls to insurance carriers to file claims on behalf of clients
• Participate in inter/intraoffice discussions and problem solving
• Complete timely review and entry of new losses
• Determine if coverage is in place and send documentation to insurance carriers
• Follow up with carriers to ensure proper documentation of acknowledgements, determinations and final settlements
• Review all determinations and discuss with carrier adjustors or TPAs
• Maintain SOPs for all claims processes
• Apply understanding of insurance policies and policy interpretation to assist clients and carriers with claim settlement
• Assist Account Service Managers, Producers, and Clients with claims questions or issues
• Escalate complex claim questions to VP Lender Services and Placement
• Complete claims reporting to Account Service Managers, Producers, Clients and Loan Protector Leadership
• Maintain an average productivity percentage of 70%

Requirements

• Prior insurance, insurance claims, or insurance agency processing a plus
• High School diploma required
• Associate or bachelor's degree preferred
• Strong written and oral communication skills
• Experience with Insurance Agency Management System (Applied or AMS)
• Experience with Microsoft Office Suite
• Excellent time management skills
• Detail oriented
• Technical learning with strong desire to learn and acquire new skills
• Ability to adapt to a changing environment and handle multiple priorities to meet deadlines
• Ability to multitask
• Ability to work independently as well as in a team environment

Core Competencies

Demonstrates expertise in insurance claims processing, including filing claims, reviewing coverage, and maintaining standard operating procedures. Proficient in communication and time management, with the ability to adapt to changing environments and manage multiple priorities effectively.

Highest-signal resume keywords

• Insurance Claims Processing
• Insurance Agency Management System
• Microsoft Office Suite
• Strong Written and Oral Communication
• Detail Oriented

Hard Skills

• Claims Filing
• Coverage Determination
• Claims Reporting
• Policy Interpretation
• SOP Maintenance

Soft Skills

• Time Management
• Adaptability
• Multitasking
• Team Collaboration
• Problem Solving

Industry Keywords

• Insurance
• Claims
• Insurance Carriers
• TPAs
• Account Service Managers

Tools & Technologies

• Applied
• AMS
• Microsoft Office Suite