Claims Specialist

Crouch Staffing Solutions, Inc. in Hewitt, Texas is hiring for a Claims Specialist for a Waco area company. All of our services are free for prospective employees.

Location: Waco, TX 76710

Job Title: Claims Specialist

Job Type: Full-time

Pay/Salary: $17.00 per hour

Hours of Work: Monday - Friday, 8 AM – 5 PM

ROLE SUMMARY:

The Claims Specialist will be responsible in processing life, disability, and waiver of premium claims by providing patient, empathetic, customer service to policy-related personnel regarding their claim. This is handled via telephone, e-mail, fax, or by sending letters through the mail. In addition, perform the various claim functions as listed below.

DAILY RESPONSIBILITITES:

Collecting information through handling incoming calls, ensuring timely and courteous verification.
Inform clients about processes, procedures, and expectations in a clear and helpful manner.
Coordinate the necessary documentation for claims processing, utilizing both internal systems and external resources.
Generate letters and update claim systems for newly reported claims.
Address and follow up on outstanding requirements for pending claims, resolving them efficiently.
Investigate and gather essential data from various sources such as beneficiaries, physician records, medical facilities, legal documents, etc., to facilitate effective claims processing.
Record detailed notes related to interactions with policy-related personnel.

REQUIREMENTS: Successful performance in this role demands the following qualifications. The criteria listed below illustrate the knowledge, skills, and abilities necessary. Reasonable accommodations may be considered for individuals with disabilities.

Effective communication skills, both written and verbal.
Proficiency in handling multi-line phone systems, with the ability to route and escalate calls as required.
Exceptional interpersonal skills, fostering positive relationships.
• Strong organizational and time management capabilities.
• Patient and empathetic demeanor.
• Active listening skills.
• Adaptability and flexibility in dynamic work environments.
• Comfortable working within fast-paced settings.
• Troubleshooting skills, varying from basic to advanced based on role and industry.
• Proficient computer skills, including data entry proficiency.
• Adherence to all applicable laws, regulations, and contractual obligations while conducting company business with ethics and integrity, aligning with the Compliance Program principles.

EDUCATION, WORK EXPERIENCE, and TRAINING REQUIREMENTS:

• High School Diploma or general education degree (GED) is required

• Preference for life claims experience, though not mandatory.

• Prior experience in call centers and customer service is strongly preferred

PLEASE APPLY AT www.crouchstaffing.com