Claims Operations Associate I

This is a fully remote position, open to applicants in California, +4 more states.

📋 Description

• Address inquiries from customers, claimants, and internal stakeholders through phone, email, and voicemail.

• Initiate and input new claims, ensuring that all information is thorough and precise.

• Examine claim submissions and documentation for any inconsistencies or omitted details.

• Utilize claim management and workflow systems to monitor activities and manage workloads effectively.

• Confirm coverage details and provide assistance with fundamental claim administration tasks.

• Execute routine claim-related transactions in accordance with established procedures.

• Investigate and collect information to address straightforward inquiries and service requests.

• Record claim activities and maintain comprehensive documentation.

• Generate and distribute general correspondence and communications related to claims.

• Collaborate with claims experts and operational partners.

• Refer non-routine or complex matters to management or senior team members.

• Uphold productivity and service standards while working remotely.

• Assist with special projects and undertake additional responsibilities as assigned.

⛳️ Requirements

• High school diploma or equivalent is required.

• Previous experience in claims operations, claims processing, billing support, customer service, policy services, or a similar insurance support role is required.

• Experience with workers’ compensation claims is preferred.

• Basic knowledge of insurance concepts, terminology, and business processes is necessary.

• Excellent verbal and written communication skills are essential.

• Ability to work accurately, manage multiple priorities, and adapt to new systems and processes is required.

• Candidates must reside within the Pacific Time Zone.

• Availability to work 37.5 hours per week from 8:00 a.m. to 4:30 p.m. Pacific Time, Monday through Friday, is mandatory.

• Must be authorized to work in the United States without current or future employment visa sponsorship.

• Self-motivation is essential in a remote work environment.

🏝️ Benefits

• Medical, dental, and vision insurance for full-time employees.

• Wellness programs.

• Parental leave options.

• Assistance with adoption.

• Tuition reimbursement available.

• Paid Time Off for full-time and eligible part-time employees.

• Paid holidays for full-time and eligible part-time employees.

• 401(k) plan with company matching contributions.

• Employee stock purchase plan.

• Commuter benefits.

• Remote work-from-home position.