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Claims Customer Service Representative
Security Mutual Life Insurance Company of New York. Respond to incoming calls and complete return calls regarding life and supplemental health claims .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in managing life and supplemental health claims through effective communication, attention to detail, and adherence to established service metrics. Proficient in utilizing multiple systems for accurate claims processing and customer service in the insurance industry.
Highest-signal resume keywords
Customer Service ExperienceClaims ProcessingHealth Insurance KnowledgeFluency In SpanishData Entry Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims ProcessingData EntryMicrosoft WordMicrosoft ExcelClaims Documentation
Soft Skills
Excellent Communication SkillsAttention To DetailEmpathyPatienceOrganizational Skills
Certifications & Qualifications
Associate’s Degree
Industry Keywords
Insurance IndustryCall Center EnvironmentCustomer ServiceHealth ClaimsConfidential Information
About the role
Key responsibilities & impact- Respond to incoming calls and complete return calls regarding life and supplemental health claims
- Process first notice of loss by gathering accurate information, verifying policy and claimant details, and initiating claims in the appropriate system
- Explain the claims process, required documentation, and next steps
- Provide accurate, up-to-date claim status and outstanding requirement information
- Demonstrate empathy, patience, and professionalism when assisting callers
- Document calls and interactions, including contact reasons, information, actions, commitments, and outcomes
- Prepare and send follow-up letters, claim forms, and other required correspondence
- Research information across multiple systems to respond to inquiries and confirm claim details
- Route inquiries and claim-related information to the appropriate Claims team or department
- Identify and escalate questions, complaints, sensitive matters, and potential issues
- Protect confidential, personal, and health information
- Maintain knowledge of claims procedures, products, forms, systems, and service expectations
- Maintain established service metrics for the Claims call queue
- Perform other duties as assigned by management
Requirements
What you’ll need- Minimum of 2 years of experience in Customer Service
- Experience in an insurance industry or call center environment
- Health insurance industry customer service experience preferred
- Fluency in Spanish a plus
- Basic knowledge of Microsoft Word and Excel
- Excellent written and verbal communication skills
- Excellent data entry skills
- Ability to perform work accurately and thoroughly
- Ability to pay close attention to detail
- Ability to prioritize and organize a heavy workload
- Ability to work a flexible schedule with occasional overtime
- Associate’s degree in business or related field
- Visa sponsorship is not available for this position
Benefits
Comp & perks- Primarily remote work with periodic time required in the assigned Company office
- Competitive salary and benefits
- Relocation assistance is not available
- Visa sponsorship is not available