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Claims Processor

Plano, Texas | Contract To Hire

Post Date: 12/04/2017 Job ID: 4806 Industry: Admin

Position:  Claims Processor

Location:  Plano, TX

Pay Rate:  $15/hour

Job Type:  Contract to Hire

This position is responsible for the administration and adjudication of insurance claims of lower severity and complexity. May also be responsible for higher level administrative support to the claim and/or recovery department.  May require an insurance adjuster license.  
Job Duties and Responsibilities
  • Processing of claim documents and inquiries related to insurance claims for multiple lines of business to authority levels of $2500-$3500
  • Handling telephone inquiries from clients and internal associates
  • ACH, Check, and draft processing to ensure accurate claim payment
  • Verify coverage via internal system and attach support documents to claims (IQQ and Unitrac)
  • Send out correspondence acknowledging and explaining the claim adjudication process to client
  • Prepare as needed daily, weekly, monthly reports associated with the internal controls of the claim and/or recovery department.
  • Prepare and submit carrier specific reports for claim dollars processed and paid
  • Provide reconciliation and balancing of claim and/or recovery proceeds and/or expenses
  • Process and adjudicate claims of lower severity and complexity associated with CPI or GAP (licensed may be required).
Qualifications (Education, Experience, Certifications & KSA)
  • High school diploma required
  • Some college or higher education preferred
  • Technical college or higher education will be strongly considered
  • Strong preference given to a candidate with an insurance license
  • Minimum 3 years of professional office experience required
  • Insurance background strongly preferred but not required
  • Creditor Placed Insurance experience also preferred, but not required
  • Strong customer service focus and a minimum of 2-3 years of previous customer service experience required
  • Strong computer skills with knowledge of lotus notes, Microsoft office suite
  • Telephone skills with a minimum of 2-3 year customer telephone experience required
  • Strong working knowledge of basic accounting principles including report generation, accts payable, invoice processing, account balancing and account reconciliation is needed
  • Strong skills in all components of Microsoft Office and report programs in Microsoft Excel.
  • Ability to pass and retain continuing education associated with obtaining and retaining a valid State of Texas Insurance Adjuster license and reciprocation among other license required states. Ability to acknowledge and respect confidential information
  • Ability to work in a professional environment and interact with Financial Institution clients
  • Ability to handle multiple tasks, meet deadlines and manage multiple support functions
  • Ability to read and apply commonsense understanding to insurance policies, contracts, loan documents, short correspondence, oral/written instructions and memos
  • Ability to deal with problems and resolve with minimal support to a proper resolution
  • Ability to organize, prioritize and execute work in a manner that meets established claim/recovery  service standards and benchmarks
  • Ability to learn quickly and adapt to different workload scenarios and multiple requests that must be done accurately, timely and thoroughly
  • Ability to use and master Microsoft office products; the ability to type at least 45 wpm
  • Strong attention to detail, producing a product that is accurate and meet with financial accounting practices
  • Ability to work independently in a fast-paced environment with the minimal support of a Manager or Supervisor
  • Ability to adjudicate claims of lower severity and complexity/ authority levels to $2500.00-$3500.00
  • Ability to analyze CPI or GAP claim information.
  • Ability to make claim benefit decisions and payments lower valued claim
  • Moderate dexterity – regular application of basic skills (calculator, keyboard, hand tools, eye/hand coordination.


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