Workers Compensation Claims Customer Care Specialist
Less than 5 years experience • Insurance
Workers Compensation Claims Customer Care Specialist - Full Remote Position with Company car. This is a client facing position that will not be handling a typical caseload but rather resolves customer inquiries, issues and complaints as well handle broker client component. The ideal candidate must live in or around Lisle, IL to handle the territory.
Serves as the main contact for Claims customers. Answers customer inquiries and resolves issues and complaints.
• Answers customers’ questions and provides them with information as appropriate
• Resolves complex questions and/or issues and provides solutions to customers.
• Investigates customer complaints to determine causes and resolves complaints in a timely manner.
• Refers inquiries to the appropriate company contact including Claims, Underwriting and Loss Control as needed.
• Contacts new customers to explain claim philosophy and process for managing injuries.
• Coordinates efforts with the Medical Provider Network contact to discuss setting up the network by account.
• Maintains accurate record keeping and ensures the integrity of data for the customer contact program.
Serves as the Customer Care Liaison for Workers’ Compensation Claims, Underwriting and Loss Control.
• Communicates directly with underwriters on agency and sales calls to discuss claims handling philosophy and to set up the special handling requirements by account.
• Partners with Loss Control and Underwriting in resolving any complaints that may surface regarding account servicing by the claims unit.
• Attends account renewal meetings to provide feedback on account specific issues.
• Notifies Claims Examiners of complaints and/or complex questions and partners with the Claims Examiners to determine solutions.
• Monitors the First Notice of Loss team’s monthly activity through statistical reports to determine efficiency in the claim reporting process for insureds.
• Consults with management to develop and implement customer care solutions.
Manages the claim review process:
• Sets claim review dates through calendaring based on policy agreements and assists in completing the reviews if needed.
• Facilitates claim reviews with the account’s Claims Examiner to communicate claim handling philosophy, current services, and service changes.
• Creates claims status reports for customer claims reviews.
• Follows through with customers after the claim review takes place to outline agreements made during the review.
Gathers data and analyzes/interprets results for the customer care program.
• Updates activity log with questions, issues, and requests to track trends.
• Analyzes activity log to identify trends and communicate findings to upper management.
• Prepares and runs customer care reports for insureds, agents, and Underwriting.
• Develops, conducts and analyzes customer surveys regarding the claims servicing experience.
High school diploma or general educationdegree (GED).
Bachelor's degree (B. A.) from four-year college or universit.
Minimum of two years experience as a Workers’ Compensation Claims Examiner.
Two years related experience and/or training in a customer service role preferred.
Excellent oral and written communication skills.
Strong working knowledge of Microsoft Office programs including Excel, Word, and PowerPoint.
Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization. Ability to speak effectively before groups of customers or employees of the organization. Ability to read, analyze, and interpret general business periodicals and to write reports, business correspondence or procedure manuals. Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public. Ability to respond to common inquiries or complaints from customers, regulatory agencies, or members of the business community.
Canon Recruiting Group, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Canon Recruiting Group, Inc. complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.