Claims Processing Clerk receives and inputs new healthcare claims, processes payments, researches billing issues, and responds to email and telephone inquiries. Evaluates claims and administers payment, denies, or returns claims according to policy provisions and organizational guidelines. Being a Claims Processing Clerk produces routine and ad hoc reports. Requires a high school diploma. Additionally, Claims Processing Clerk typically reports to a supervisor. The Claims Processing Clerk works under the close direction of senior personnel in the functional area. Possesses a moderate understanding of general aspects of the job. May require 0-1 year of general work experience. (Copyright 2024 Salary.com)
Job Description
As a Warranty Claims Processing Agent, you will review and validate claims submitted by the outside sales force as well as installer and dealer network. This role requires construction knowledge and skills in service and warranty operations, strong organization and communication skills, and lends itself to considerable career growth potential. We offer a fun and challenging work environment where the right candidate will learn and grow with the company. We pride ourselves on teamwork and quality customer service.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Review warranty documentation for validating warranty claims
Support the outside sales force as well as installer and dealer network in the processing of those claims selected for review through the systematic examination of all submitted warranty claims
Determine warranty repair eligibility in accordance with program guidelines through technical analysis of repair, adherence to warranty policies and procedures and proper claiming of parts and labor
Track status of submitted claim documentation through completion
Provide stakeholders with feedback on warranty claim concerns detected while providing exceptional customer service
Advise Field Service Representatives of warranty account status with emphasis on unsettled claims
Track claim payment system for potential issues and review by Clients claim systems team
Job Requirements
COMPETENCIES and CHARACTERISTICS (preferred)
Knowledge Retention - To provide the highest quality support to customers, agents must be able to learn and memorize a large amount of information
Detail-oriented with strong organizational, negotiation, influential, and customer service skills, able to work well under deadlines in a changing environment and perform multiple tasks effectively and concurrently
Flexibility Agent should be able to aid various types of customers from different industries. They should have the ability to focus on the warranty issues, provide solutions while maintaining a professional demeanor always
Friendly - Project a warm and friendly image, consistently maintain a positive demeanor
Customer service focused - Must have the ability to stay calm in difficult situations. Must be able to gain and maintain control of customer conversations while providing world class customer service
Effective Communication Skills both written and spoken - Strong communication skills, listening to the caller, digesting the information and effectively conveying a solution quickly and efficiently
Strong analytical and problem-solving skills - Must be able to find workable solutions for any problems they might face
EDUCATION and/or EXPERIENCE
Minimum of 5 years building industry claims handling experience
Minimum 1-2 years window & door technical background
Working experience with dealer and building contractor operations processes
High school diploma or General Equivalency Diploma (GED)
Proficiency with MS Office products (Outlook, Word, Excel,) and claims related software applications
The ability to perform basic math calculations (addition, subtraction, multiplication and division) as well as the calculation of averages and percentages
Ability to interpret an extensive variety of technical instructions and deal with several abstract and concrete variables
LANGUAGE SKILLS
Full professional proficiency in English
Minimum professional proficiency in Spanish is a plus