Hybrid Claims Specialist II: Complex Resolution

Continental General; Austin (TX); Hybrid; USD 42,000 - 65,000; Full time

Job summary

Continental General is seeking a Claims Specialist II in the Austin, TX area to deliver responsive, customer-focused support throughout the claims process. You will handle moderately complex claim servicing tasks, review details, communicate updates, and collaborate with internal teams and external partners to ensure accurate resolutions.

The ideal candidate brings strong communication skills, attention to detail, and a solid background in insurance claims, with a commitment to compliance and

Qualifications

• High School Diploma required or equivalent.
• Associate degree or higher in business, insurance, healthcare administration, or related field preferred.
• 3+ years of experience in insurance claims or related field.
• Experience interpreting policy provisions and researching claim information.
• Demonstrated technical knowledge in product and industry areas.

Responsibilities

• Process and resolve moderately complex claim servicing requests per policy and procedures.
• Review claim details and payment history to identify issues and determine resolution.
• Research complex servicing items, including discrepancies and adjustments.
• Coordinate with internal departments, vendors, providers, and insureds to obtain info.
• Provide clear updates and maintain professional communication with customers.

Skills

Customer service

Claims processing

Policy interpretation

Documentation

Communication

Education

High School Diploma

Associate degree or higher in business/insurance

Job description

Continental General is seeking a Claims Specialist II in the Austin, TX area to deliver responsive, customer-focused support throughout the claims process. You will handle moderately complex claim servicing tasks, review details, communicate updates, and collaborate with internal teams and external partners to ensure accurate resolutions.

The ideal candidate brings strong communication skills, attention to detail, and a solid background in insurance claims, with a commitment to compliance and